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Evaluating the Function of the Foot Core System in the Elderly
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RELIABILITY, COMPARABILITY, AND VALIDITY OF FOOT INVERSION AND EVERSION STRENGTH MEASUREMENTS USING A HAND-HELD

Martin Alfuth, Magali Murielle Hahm1

  • 1German Sport University Cologne, Department of Further Education, MSc Sport Physiotherapy, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany.

International Journal of Sports Physical Therapy
|February 23, 2016
PubMed
Summary

Hand-held dynamometer (HHD) measurements of foot inversion and eversion strength are reliable across different positions. However, HHDs underestimate torque output compared to isokinetic dynamometry, with variations between supine/sitting and side-lying positions.

Keywords:
different test positionsdynamometryeversioninversionreproducibility

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Area of Science:

  • Biomechanics
  • Musculoskeletal assessment
  • Physical therapy instrumentation

Background:

  • Conflicting evidence exists regarding the validity and reliability of hand-held dynamometer (HHD) measurements for lower extremity strength in healthy individuals.
  • Previous studies on foot inversion/eversion strength with HHD primarily involved participants with clinical conditions and varied positions.

Purpose of the Study:

  • To assess the intra- and inter-tester reliability of foot inversion and eversion strength measurements using a belt-stabilized HHD in different participant positions.
  • To compare the comparability of strength measurements obtained in supine, sitting, and side-lying positions.
  • To determine the concurrent validity of HHD measurements against an isokinetic dynamometer.

Main Methods:

  • Maximal isometric foot inversion and eversion torques were measured in 30 healthy adults using a belt-stabilized HHD in supine, sitting, and side-lying positions.
  • Measurements were repeated by two physiotherapists over two days and compared with isokinetic dynamometry.
  • Intra-class correlation coefficients (ICC) were used to determine reliability and validity; ANOVA and Bland-Altman plots analyzed differences between positions and devices.

Main Results:

  • Intra-tester reliability for inversion and eversion was fair to excellent (ICC 0.598-0.828).
  • Inter-tester reliability was excellent for eversion (ICC 0.773-0.860) and fair to excellent for inversion (ICC 0.519-0.879).
  • Concurrent validity showed low to fair agreement (ICC 0.205-0.562) with isokinetic measurements, which were consistently higher.

Conclusions:

  • HHD measurements of foot inversion and eversion strength demonstrate good reliability across different positions (supine, sitting, side-lying).
  • HHD measurements consistently underestimate torque output compared to isokinetic dynamometry.
  • While supine and sitting positions yield comparable HHD results, the side-lying position differs significantly.