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Reliability of quantifying foot and ankle muscle strength in very young children
Kristy J Rose1, Joshua Burns, Monique M Ryan
1Discipline of Paediatrics and Child Health, University of Sydney, Sydney and Institute for Neuromuscular Research, Children's Hospital at Westmead, Locked Bag 4001, Westmead NSW 2145, Australia. KristyR2@chw.edu.au
Insights
Hand-held dynamometry reliably measures foot and ankle strength in young children aged 2-4 years. This technique can aid in diagnosing neuromuscular disorders and tracking disease progression in pediatric populations.
Area of Science:
- Pediatric physical therapy
- Neuromuscular research
- Clinical trial methodology
Background:
- Preschool children with neuromuscular disorders are often excluded from clinical trials.
- Lack of reliable and objective strength measures hinders pediatric research participation.
- Accurate strength assessment is crucial for diagnosis and monitoring disease progression.
Purpose of the Study:
- To evaluate the reliability of hand-held dynamometry for measuring foot and ankle muscle strength in healthy preschool-aged children.
- To establish the feasibility of using this method in clinical trials involving young children.
Main Methods:
- Sixty healthy children aged 2-4 years participated.
- Foot inversion, eversion, ankle plantarflexion, and dorsiflexion strength were measured using a hand-held dynamometer.
- Intrarater and interrater reliability were assessed using intraclass correlation coefficients (ICCs).
Main Results:
- High intrarater (ICC = 0.85–0.94) and interrater (ICC = 0.88–0.96) reliability was observed for all muscle groups.
- Reliability was highest in 3- and 4-year-olds and lowest in 2-year-olds.
- Standard error of measurement (SEM) values were low, indicating precision.
Conclusions:
- Hand-held dynamometry is a reliable method for assessing foot and ankle muscle strength in very young children.
- This technique can potentially facilitate the inclusion of preschoolers in clinical trials.
- Reliable strength measures can improve diagnosis and characterization of neuromuscular disorders affecting the foot and ankle.
Abstract:
Preschool-age children with neuromuscular disorders are often excluded from clinical trials due to the lack of reliable and objective strength measures. We evaluated the reliability of measuring foot and ankle muscle strength in 60 healthy children age 2-4 years. The strength of foot inversion and eversion, ankle plantarflexion, and dorsiflexion was measured using a hand-held dynamometer. Intrarater and interrater reliability of two assessors was determined for each muscle group using intraclass correlation coefficients (ICCs), 95% confidence intervals (CIs), and standard error of measurement (SEM). For all muscle groups intrarater (ICC(2,2) = 0.85-0.94, 95% CI = 0.75-0.96, SEM = 1.5-4.7 N) and interrater (ICC(2,1) = 0.88-0.96, 95% CI = 0.81-0.98, SEM = 1.2-4.6 N) reliability was high for all children. As expected, reliability was generally highest in 3- and 4-year-old children and lowest in 2-year-old children. Hand-held dynamometry can reliably measure foot and ankle strength in very young children and may help aid in diagnosis and in characterizing disease progression in disorders affecting the foot and ankle.
