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Hand-held Dynamometer Positioning Impacts Discomfort During Quadriceps Strength Testing: A Validity and Reliability

Evan M Hansen1, Caitlyn N McCartney1, Ryan S Sweeney1

  • 1Department of Physical Therapy, Creighton University, Omaha, NE, USA.

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A modified hand-held dynamometer (HHD) setup significantly reduces discomfort during quadriceps strength testing. This new configuration is a valid and reliable alternative to traditional methods for clinical use.

Keywords:
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Area of Science:

  • Biomechanics
  • Clinical Measurement
  • Rehabilitation Science

Background:

  • Belt-stabilized hand-held dynamometers (HHDs) are used to measure quadriceps strength.
  • Participant discomfort at the tibia interface is a limitation of standard HHD configurations.
  • Alternative methods are needed to improve patient comfort during strength assessments.

Purpose of the Study:

  • To compare discomfort levels between a modified HHD, standard HHD, and isokinetic dynamometer.
  • To assess the validity and reliability of the modified HHD for measuring quadriceps strength.

Main Methods:

  • Twenty healthy participants performed isometric knee extension using three conditions: isokinetic dynamometer, standard HHD, and modified HHD.
  • Discomfort was measured using a Visual Analog Scale (VAS).
  • Torque, validity (Pearson correlations), and reliability (ICC2,1) were analyzed.

Main Results:

  • The modified HHD configuration significantly reduced discomfort compared to the standard HHD.
  • The isokinetic dynamometer yielded the least discomfort.
  • High correlations (r=.87 to .93) and good reliability (ICC2,1=0.93) were found for the HHD configurations.

Conclusions:

  • A modified belt-stabilized HHD configuration, interfacing with a table leg, is more comfortable than the standard setup.
  • This modified HHD is a valid and reliable tool for assessing isometric quadriceps strength in clinical settings.
  • It offers a comfortable alternative to the isokinetic dynamometer at 90° knee flexion.