Repeatability and accuracy of a foot muscle strength dynamometer

Toe flexor strength is a pivotal biomechanical contributor for effecting balance and gait. However, there are limited reports that evaluate measurement accuracy and repeatability of this important attribute. Dynamometers are designed to measure force which can be used to derive joint torque if the perpendicular distance to the joint axis is known. However, an accurate and reliable measurement method to assess the ability of the toe flexor muscles to produce torque, is lacking. Here we describe a new device and method, designed to quantify the toe flexor torque developed at the metatarsal phalangeal joint. We evaluate measurement bias and the ability of the instrument to consistently measure what it is supposed to measure (Interclass Correlation Coefficient). Results suggest that our device is an accurate tool for measuring angle and torque with a small (0.10° and 0.07 Nm, respectively) bias. When tested for reliability and repeatability in measuring toe flexor torque (n = 10), our device showed high interclass correlation (ICC = 0.99), small bias (-1.13 Nm) and small repeatability coefficient (CR = 3.9). We suggest mean bias and CR to be reported for future measurement methods and our protocol used as standard approach to measure maximal toe flexor torque.