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Updated: Jul 26, 2025

Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
Published on: December 13, 2024
Reliability and criterion validity of handheld dynamometry for measuring trunk muscle strength in people with and
Shouq Althobaiti1, Deborah Falla2
1Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, UK; Physical Therapy Department, College of Applied Medical Science, Taif University, Taif, Saudi Arabia.
Background:
Evaluating trunk strength is an important aspect of the physical examination of people with low back pain (LBP). Thus, reliable, valid, and easily applied measurement tools are needed to quantify trunk muscle strength and monitor changes in response to interventions.
Objectives:
To determine within-day and between-day test re-test reliability and criterion validity of a handheld dynamometer (HHD) to evaluate maximum isometric trunk strength in people with chronic LBP and asymptomatic individuals.
Design:
Reliability and criterion validity study.
Methods:
Twenty adult participants with chronic, non-specific LBP and 35 asymptomatic individuals participated. Isometric trunk flexion, extension, and rotation strength were evaluated with the HHD (Active force 2) and the within-day and between-day reliability were determined with intraclass correlation coefficients (ICC2,1) and the standard error of the measurements (SEM), minimal detectable change (MDC), and the limits of agreement (LOA) using Bland-Altman plots. Criterion validity was evaluated using Pearson correlation coefficients to compare HHD measurements to isokinetic dynamometry for both isometric trunk flexion and extension strength.
Results:
Good to excellent within-day and between-day reliability was observed for people with LBP and asymptomatic individuals with (ICC2,1) of 0.73-0.93 and 0.62-0.92 respectively. A moderate to strong correlation was found between measurements with the HHD and the isokinetic dynamometer with a correlation of r = 0.68-0.78 and r = 0.56-0.59 for people with LBP and asymptomatic participants respectively.
Conclusion:
A HHD is a reliable, valid, and clinically applicable tool for the measurement of trunk strength in adults with and without chronic LBP.

