Comparison of the Diagnostic Accuracy of Dynamic Versus Isometric Hand Held Dynamometry in the Detection of Asymmetrical Quadriceps Muscle Strength in Persons with and Without Suspected Unilateral Lower Extremity Dysfunction

Comparison of the Diagnostic Accuracy of Dynamic Versus Isometric Hand Held Dynamometry in the Detection of Asymmetrical Quadriceps Muscle Strength in Persons with and Without Suspected Unilateral Lower Extremity Dysfunction

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Background. Diagnostic accuracy of manual methods to detect strength deficits in the clinical and research settings has been questionable. Hand held dynamometers provide a quantitative means for manual muscle strength assessment. To date, literature investigating the reliability of hand-held dynamometry has been predominantly limited to the examination of isometric muscle contraction. However, most functional activities involve movements that are not reflected with solely isometric measures of muscle strength. A protocol using dynamic hand held dynamometry has been developed to measure quadriceps strength using a concentric contraction. Objective. The objective of this study was to examine the diagnostic accuracy of dynamic and isometric hand held dynamometry (HHD) in detection of asymmetric strength of the quadriceps in persons with and without suspected lower extremity dysfunction. Design. Twenty-six subjects with an age range of 18 to 56 years (mean of 32.6) were tested in random order using isometric HHD, dynamic HHD, isometric Biodex dynamometry, and isokinetic Biodex dynamometry. HHD was performed by two licensed PTs. Determination of asymmetrical strength difference was obtained using a Biodex dynamometry. Comparison of dynamic HHD to isokinetic Biodex dynamometry, and isometric HHD to isometric Biodex dynamometry was performed at 10, 15, and 20 percent difference between sides. Results. Dynamic HHD was correlated to isokinetic Biodex testing (r=0.69), and isometric HHD was correlated to isometric Biodex testing (r--0.78). Diagnostic accuracy of dynamic HHD was 0.52 at 10%, 0.58 at 15%, and 0.88 at 20% difference. Diagnostic accuracy of isometric HHD was 0.60 at 10%, 0.63 at 15%, and 0.85 at 20% difference. Conclusions. Dynamic HHD elicited lower mean force output than isometric HHD. Diagnostic accuracy results suggest that isometric and dynamic HHD are similar. Further study utilizing dynamic HHD should be performed.The revised scale by Daniels and Worthingham has exhibited predominance in the research and clinical setting and its ... Therefore, it is critical that clinicians use very descriptive and specific manual muscle testing scales, especially when anbsp;...


Title:Comparison of the Diagnostic Accuracy of Dynamic Versus Isometric Hand Held Dynamometry in the Detection of Asymmetrical Quadriceps Muscle Strength in Persons with and Without Suspected Unilateral Lower Extremity Dysfunction
Author: Joshua Joseph Canfield
Publisher:ProQuest - 2007
ISBN-13:

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