Munenori Katoh

Reliability of Isometric Knee Extension Muscle Strength Measurements of Healthy Elderly Subjects Made with a Hand-held Dynamometer and a Belt.

[Purpose] The purpose of this study was to examine the reliability of three isometric knee extension strength measurements (IKE) made with a hand-held dynamometer (HHD) and a belt of healthy elderly living in the community as subjects. [Subjects] The subject cohort consisted of 186 healthy elderly people, aged 65 to 79 years, living in local communities. [Methods] IKE of the leg subjects used to kick a ball was measured. IKE of each subject was measured three times using an HHD-belt at intervals of 30 seconds. The reliability of the larger of the first two measurements (LV2) as well as the third measurement (3V) was investigated. [Results] The intraclass correlation coefficients [ICC (1, 1)] for LV2 and 3V were 0.955. Bland-Altman analysis showed a fixed bias, and the limits of agreement ranged from −5.6 to 4.6. [Conclusion] The ICC results show that the test-retest reproducibility of IKE measurements of healthy elderly subjects using an HHD-belt is high. However, Bland-Altman analysis showed a fixed bias, suggesting the need for three measurements.

An Investigation into Reliability of Knee Extension Muscle Strength Measurements, and into the Relationship between Muscle Strength and Means of Independent Mobility in the Ward: Examinations of Patients Who Underwent Femoral Neck Fracture Surgery.

[Purpose] The purpose of the present study was to investigate the reliability of isometric knee extension muscle strength measurement of patients who underwent femoral neck fracture surgery, as well as the relationship between independent mobility in the ward and knee muscle strength. [Subjects] The subjects were 75 patients who underwent femoral neck fracture surgery. [Methods] We used a hand-held dynamometer and a belt to measure isometric knee extension muscle strength three times, and used intraclass correlation coefficients (ICCs) to investigate the reliability of the measurements. We used a receiver operating characteristic curve to investigate the cutoff values for independent walking with walking sticks and non-independent mobility. [Results] ICCs (1, 1) were 0.9 or higher. The cutoff value for independent walking with walking sticks was 0.289 kgf/kg on the non-fractured side, 0.193 kgf/kg on the fractured side, and the average of both limbs was 0.238 kgf/kg. [Conclusion] We consider that the test-retest reliability of isometric knee extension muscle strength measurement of patients who have undergone femoral neck fracture surgery is high. We also consider that isometric knee extension muscle strength is useful for investigating means of independent mobility in the ward.

Test-retest reliability of isometric shoulder muscle strength measurement with a handheld dynamometer and belt.

[Purpose] The aim of this study was to develop a method of measuring isometric shoulder joint muscle strength using a handheld dynamometer with a belt and investigate its test-retest reliability. [Subjects] The subjects comprised 40 healthy adults. [Methods] Six types of isometric shoulder muscle strength were measured twice, and reliability was assessed. [Results] The intraclass correlation coefficient (1, 1) values ranged from 0.976 to 0.902. The result of a Bland-Altman analysis showed differences in the types of errors between measurement items. [Conclusion] The relative reliability of isometric shoulder muscle measurement using a handheld dynamometer with a belt was high. However, analysis of absolute reliability revealed errors that may affect interpretation of values; therefore, it was considered that adapting the greater of two measurement values is appropriate.

Reliability of isometric knee extension muscle strength measurements made by a hand-held dynamometer and a belt: a comparison of two types of device

[Purpose] The purpose of the present study was to compare the reliability of 2 hand-held dynamometers (HHD-1, 2) with different designs, by performing isometric knee muscle extension measurements two times each. [Subjects] The subjects were 40 young healthy adults. [Methods] The reliability of the measurements was examined using Bland-Altman analysis. [Results] Bland-Altman analysis found a fixed bias in measurements made by HHD-1 with an average limits of agreement (LOA) value of −2.1 kgf. For HHD-2, only random errors were detected, and the minimal detectable change (MDC) was 11.4 kgf. Fixed biases were observed between the two devices with an average LOA value of 2.2 kgf. When the bodyweight ratio was used, fixed biases were observed in measurements made by both devices, and the average value of LOA was −0.03 kgf/kg. The comparison of the two devices revealed only random errors, and MDC was 0.22 kgf/kg. [Conclusion] For HHD measurements using these two devices, the appropriate number of measurements is two times, and comparison of measurement values between the two devices should be avoided.

Limits of the manipulative-fixed method for measurement of shoulder joint horizontal adduction muscle strength using a handheld dynamometer.

[Purpose] The aim of this study was to verify the limit of isometric muscle strength of shoulder joint horizontal adduction using handheld dynamometer (HHD) manipulated by hand (referred to as the manipulative-fixed method). [Subjects and Methods] The subjects were 33 healthy college students. The examiner was a healthy college student. Shoulder joint horizontal adductor muscle strength was measured using HHD with the subject in the supine position. The belt-fixed and manipulative-fixed methods were used to secure the HHD sensor unit. The limitations of the manipulative-fixed method were assessed by simple regression analysis, in which the participants were divided into 2 groups according to a branch point. The slope of the straight line of the graph was visualized. [Results] Single regression analysis of the <30 kgf group revealed significant results. The results of single regression of the >30 kgf group were not significant. [Conclusion] The manipulative-fixed method is simple to perform. However, there exists the possibility that the actual muscle strength is not measurable by this method. The measurement limit of the shoulder horizontal adduction strength with the manipulative-fixed method was 30 kgf in the case of the examiner in the present study. The fixed limit was also found to influence in the muscle strength of the upper limbs.

Absolute reliability of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer

[Purpose] The aim of this study was to verify the absolute reliability of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer (HHD). [Subjects and Methods] The subjects were 33 healthy college students. The measurements were made three times with the HHD fixed using a belt (BFHHD) or with the examiner’s hand (conventional method; HFHHD). The absolute reliability of measurements was verified using Bland-Altman analysis, both in the all subjects group and a group of subjects showing measurements less than a fixed limit of 30 kgf. [Results] In the <30 kgf group, a systematic bias was not observed, and BFHHD values were greater than HFHHD values. BFHHD values in the all subjects group showed a systematic bias; the 3rd measurement value was less than the maximum value obtained during the 1st and 2nd measurements. [Conclusion] For obtaining an acceptable value during clinical measurements of horizontal adductor muscle strength, single measurements obtained using an HFHHD in the case of a <30 kgf group and the maximum value of two measurements obtained using a BFHHD are reliable.

Reliability and validity of an ultrasound-based imaging method for measuring interspinous process distance in the lumbar spine using two different index points.

[Purpose] This study assessed the reliability and validity of an ultrasound-based imaging method for measuring the interspinous process distance in the lumbar spine using two different index points. [Subjects and Methods] Ten healthy males were recruited. Five physical therapy students participated in this study as examiners. The L2–L3 interspinous distance was measured from the caudal end of the L2 spinous process to the cranial end of the L3 spinous process (E-E measurement) and from the top of the L2 spinous process to the top of the L3 spinous process (T-T measurement). Intraclass correlation coefficients were calculated to estimate the relative reliability. Validity was assessed using a model resembling the living human body. [Results] The reliability study showed no difference in intra-rater reliability between the two measurements. However, the E-E measurement showed higher inter-rater reliability than the T-T measurement (Intraclass correlation coefficients: 0.914 vs. 0.725). Moreover, the E-E measurement method had good validity (Intraclass correlation coefficients: 0.999 and 95% confidence interval for minimal detectable change: 0.29 mm). [Conclusion] These results demonstrate the high reliability and validity of ultrasound-based imaging in the quantitative assessment of lumbar interspinous process distance. Of the two methods, the E-E measurement method is recommended.

Validity and reliability of isometric muscle strength measurements of hip abduction and abduction with external hip rotation in a bent-hip position using a handheld dynamometer with a belt

[Purpose] This study aimed to investigate the relatedness, reliability, and validity of isometric muscle strength measurements of hip abduction and abduction with an external hip rotation in a bent-hip position using a handheld dynamometer with a belt. [Subjects and Methods] Twenty healthy young adults, with a mean age of 21.5 ± 0.6 years were included. Isometric hip muscle strength in the subjects’ right legs was measured under two posture positions using two devices: a handheld dynamometer with a belt and an isokinetic dynamometer. Reliability was evaluated using an intra-class correlation coefficient (ICC); relatedness and validity were evaluated using Pearson’s product moment correlation coefficient. Differences in measurements of devices were assessed by two-way ANOVA. [Results] ICC (1, 1) was ≥0.9; significant positive correlations in measurements were found between the two devices under both conditions. No main effect was found between the measurement values. [Conclusion] Our findings revealed that there was relatedness, reliability, and validity of this method for isometric muscle strength measurements using a handheld dynamometer with a belt.

Intrarater reliabilities of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer for geriatric and stroke patients

[Purpose] This study aimed to verify the appropriate number of measurements and the intrarater reliabilities of shoulder joint horizontal adductor muscle strength measurements using a handheld dynamometer (HHD) for geriatric and stroke patients. [Subjects and Methods] The subjects were 40 inpatients, who were divided into two groups: 20 stroke patients in the stroke group (SG), and 20 geriatric patients in the no-stroke group (N-SG). Measurements were performed three times using an HHD with a belt. The reliability was verified using Bland-Altman analysis and the intraclass correlation coefficient (ICC). [Results] ICC (1, 1) was >0.9. A systematic bias was not observed between the first and second measurement values except for the right side in N-SG. A systematic bias between the maximum value obtained during the first and second measurements and third measurement value was observed on the left side in N-SG, and on the non-paralyzed side in SG: the third measurement values were small in both cases. [Conclusion] Intrarater reliabilities were high for shoulder horizontal adductor strength measurements using an HHD with a belt for geriatric and stroke patients. Taking the systematic bias into consideration, these findings suggest that the required number of measurements is two.

Effects of trunk stability on isometric knee extension muscle strength measurement while sitting.

[Purpose] This study aimed to investigate the effect of trunk stability on isometric knee extension muscle strength measurement while sitting by performing simultaneous measurements with a handheld dynamometer (HHD) and an isokinetic dynamometer (IKD) in the same seated condition. [Subjects and Methods] The subjects were 30 healthy volunteers. Isometric knee extension muscle strength was simultaneously measured with a HHD and an IKD by using an IKD-specific chair. The measurement was performed twice. Measurement instrument variables and the number of measurements were examined by using the analysis of variance and correlation tests. [Results] The measurement instrument variables and the number of measurements were not significantly different. The correlation coefficients between the HHD and IKD measurements were ≥0.96. [Conclusion] Isometric knee extension muscle strength measurement using the HHD in the sitting position resulted in a lower value than that using the IKD, presumably because of the effect of trunk stability on the measurement. In the same seated posture with trunk stability, no significant difference in measurement values was observed between the HHD and IKD. The present findings suggest that trunk stability while seated during isometric knee extension muscle strength measurement influenced the HHD measurement.