Influence of Testing Position on the Reliability of Hip Extensor Strength Measured by a Handheld Dynamometer

The Kaohsiung Journal of Medical Sciences - Tập 25 - Trang 126-132 - 2009
Yi-Jing Lue1,2, Ching-Lin Hsieh3, Mei-Fang Liu1,2, Shih-Fen Hsiao1,2, Shu-Mei Chen1,2, Jau-Hong Lin1,2, Yen-Mou Lu4
1Department of Physical Therapy, College of Health Science, Kaohsiung Medical University, Taipei, Taiwan
2Department of Physical Medicine and Rehabilitation, National Taiwan University, Taipei, Taiwan
3Department of School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
4Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung, National Taiwan University, Taipei, Taiwan

Tóm tắt

Hip extensors belong to an important muscle group that controls standing, walking and other functional activities. The prone position (PP) is commonly used to measure the strength of the hip extensors; however, the reliability of such measurements is poor. The aim of this study was to determine the effect of different testing positions, that is, the PP and the prone standing position (PSP), on the reliability of measurements of hip extensor strength. Intrasession reliability and interrater reliability studies were performed on 47 and 16 normal subjects, respectively. The muscle strength of the hip extensors was tested in both the PP and PSP. A handheld dynamometer and break test were used to measure the strength. Relative reliability and absolute reliability were assessed in both PP and PSP. For relative reliability, the intraclass correlation coefficient (ICC) was used to examine the level of reproducibility among measurements. Absolute reliability, the smallest real difference (SRD), was used to provide information on measurement error. The results showed that the reliability was better in PSP than in PP. For relative reliability, the values of ICCs were excellent in the intrasession reliability study, in both PP (ICC1,3 = 0.92) and PSP (ICC1,3 = 0.94). However, the interrater reliability was only excellent in PSP; the ICC2,3 were 0.92 in PSP and 0.65 in PP. For absolute reliability, the values of the SRD were much lower in PSP (29.8) than in PP (71.8), indicating that the measurement of muscle strength in PSP was more stable and had smaller measurement error than in PP. Changing the testing position from the traditional “prone” to “prone‐standing” effectively improved both the relative reliability and the absolute reliability.

Tài liệu tham khảo

10.1053/apmr.2000.7174 10.1093/ptj/63.10.1597 10.1053/apmr.2001.18584 10.1016/j.apmr.2003.09.019 10.1016/j.jbmt.2007.01.005 10.1016/S0268-0033(00)00002-4 Walheim G, 1990, Postoperative improvement of walking capacity in patients with trochanteric hip fracture: a prospective analysis 3 and 6 months after surgery, J Orthop Trauma, 4, 137, 10.1097/00005131-199004020-00006 Barbic S, 2008, Test position and hip strength in healthy adults and people with chronic stroke, Arch Phys Med Rehabil, 89, 784, 10.1016/j.apmr.2007.10.020 Lue YJ, 2000, Knee isokinetic strength and body fat analysis in university students, Kaohsiung J Med Sci, 16, 517 10.1093/ptj/76.3.248 10.1016/S0003-9993(00)90050-9 Hiplop HJ, 1995, Daniels and Worthingham's Muscle Testing: Technique of Manual Examination 10.1016/S0003-9993(03)00379-4 10.1016/j.apmr.2003.07.013 10.1111/j.1469-8749.2007.00106.x 10.2165/00007256-199826040-00002 10.1177/096228029900800204 10.2165/00007256-200030010-00001 Liaw LJ, 2008, The relative and absolute reliability of two balance performance measures in chronic stroke patients, Disabil Rehabil, 30, 651 10.1177/1545968306297864 10.1053/apmr.2002.32743 10.1023/A:1013138911638 10.1097/00004356-200306000-00002 10.1080/16501970410017215 Fleiss JL, 1981, Statistical Methods for Rates and Proportions Smith LK, 1996, Brunnstrom's Clinical Kinesiology Hamilton N, 2008, Kinesiology Scientific Basis of Human Motion 10.2106/00004623-197456080-00006 Goldsmith CH, 1993, Criteria for clinically important changes in outcomes: development, scoring and evaluation of rheumatoid arthritis patient and trial profiles. OMERACT Committee, J Rheumatol, 20, 561 10.1097/01.phm.0000176452.17771.20 10.1053/apmr.2002.33728 10.1016/j.apmr.2006.09.011 10.2340/16501977-0107 10.1016/j.apmr.2007.10.028 10.1053/apmr.2000.7165 10.1136/bmj.328.7441.702 10.1191/0269215505cr854oa