Effects of Examiner Strength on Reliability of Hip-Strength Testing Using a Handheld Dynamometer

2014 ◽  
Vol 23 (1) ◽  
pp. 56-64 ◽  
Author(s):  
David A. Krause ◽  
Mathew D. Neuger ◽  
Kimberly A. Lambert ◽  
Amanda E. Johnson ◽  
Heather A. DeVinny ◽  
...  
Keyword(s):  
Interrater Reliability ◽  
External Rotation ◽  
Strength Testing ◽  
Intrarater Reliability ◽  
Hip Strength ◽  
Significant Difference ◽  
Hip Abduction ◽  
Hip Muscles ◽  
Torque Values ◽  
Hip Extension

Context:Hip-muscle impairments are associated with a variety of lower-extremity dysfunctions. Accurate assessment in the clinical setting can be challenging due to the strength of hip muscles relative to examiner strength.Objective:To examine the influence of examiner strength and technique on manual hip-strength testing using a handheld dynamometer.Design:Repeated measures.Setting:Research laboratory.Participants:30 active adults (age 24 ± 1.4 y).Interventions:Three examiners of different strength performed manual muscle tests (MMT) in 2 different positions for hip extension, abduction, and external rotation using a MicroFet handheld dynamometer. Examiner strength was quantified via a 1-repetition-maximum leg press and chest press with a Keiser A420 pneumatic resistance machine.Main Outcome Measures:Intrarater reliability (ICC3,1), interrater reliability (ICC2,1), and measured torque values.Results:Intrarater reliability for all measurements ranged from .82 to .97. Interrater reliability ranged from .81 to .98. Main effects for hip extension revealed a significant difference in torque values between examiners and between techniques. For the short-lever hip-abduction and seated hip-external-rotation tests, there was a significant difference between examiners. There was no significant difference in measured torque values between examiners with the long-lever hip-abduction or the prone hip-external-rotation tests.Conclusions:MMT of the hip may be performed with high reliability by examiners of different strength. To obtain valid MMT measurements of hip muscles, examiners must consider their own strength and testing techniques employed. The authors recommend a long-lever technique for hip abduction and a prone position for testing hip external rotation to minimize the influence of examiner strength. Both positions appear to provide mechanical advantages to the examiner compared with the alternative techniques. The authors are unable to recommend a preferred hip-extension-testing technique to minimize the influence of examiner strength.

Reliability of the Hand-Held Dynamometer During Hip Isometric Strength Testing Both With and Without a Stabilization Strap

2020 ◽  
Vol 25 (1) ◽  
pp. 37-42
Author(s):  
Megan Q. Beard ◽  
Samantha A. Boland ◽  
Phillip A. Gribble
Keyword(s):  
Lower Extremity ◽  
Clinical Setting ◽  
External Rotation ◽  
High Reliability ◽  
Isometric Strength ◽  
Strength Testing ◽  
Hip Strength ◽  
Lower Extremity Injuries ◽  
Hip Abduction ◽  
Extremity Injuries

Decreased hip strength is often present in patients with chronic overuse lower extremity injuries. The hand-held dynamometer (HHD) can be used in a clinical setting to quantify hip strength; however, reliability of the device remains unclear. The purpose of this study was to determine the interexaminer and intersession reliability of a HHD when measuring isometric hip abduction (HABD) and external rotation (HER) strength, both with and without a fixed strap. The HHD had good to high reliability regardless of examiner, session, or stabilization when measuring HABD (ICC = 0.885–0.977) and HER (ICC = 0.879–0.958) isometric strength. HHD is an appropriate instrument for measuring isometric hip strength.

scholarly journals Weight-Bearing Versus Traditional Strength Assessments of the Hip Musculature

2021 ◽  
Vol 56 (2) ◽  
pp. 191-196
Author(s):  
Bret G. Freemyer ◽  
Anthony Urbi ◽  
Trevor Torigoe ◽  
Christopher Stickley
Keyword(s):  
Female Athletes ◽  
External Rotation ◽  
Weight Bearing ◽  
Hip Strength ◽  
P Values ◽  
Additional Information ◽  
Hip Muscle ◽  
Hip Abduction ◽  
And Function ◽  
Hip Extension

Context Traditional nonweight-bearing (NWB) hip-strength assessments may not directly translate to functional strength during weight-bearing (WB) activity. How NWB assessments of hip muscle strength compare with WB assessments in various positions is currently unknown. Objective To determine the magnitude of the differences and correlations between NWB hip strength and WB functional strength during the squatting and lunge (LNG) positions in female athletes. Design Crossover design. Setting Laboratory. Patients or Other Participants Female athletes (N = 51, age = 16.2 ± 3.5 years, height = 161.5 ± 8.3 cm, mass = 58.3 ± 11.6 kg). Intervention(s) Isometric resistance (N/kg) was determined for the dominant and nondominant limbs via WB assessments (squat-bilateral [legs tested simultaneously], squat-unilateral, and lunge positions) and NWB assessments (hip external rotation [HER], hip extension [HEXT], and hip abduction [HAB]). Main Outcome Measure(s) To compare differences between positions (P ≤ .05), we used effect sizes (d) and matched-pairs t tests, and we calculated Pearson r and R2 values. Results During the squat-bilateral on the dominant limb, females produced the most hip torque (6.13 ± 1.12 N/kg). The magnitudes of differences were very large compared with HER (3.96 ± 0.83, d = 2.2), HEXT (3.22 ± 0.69, d = 3.2), and HAB (3.80 ± 1.01, d = 2.2; all P values ≤ .01), and positions were moderately correlated (r = 0.347–0.419, R2 = 0.12–0.18). The lunge position produced the least amount of torque in the dominant limb (2.44 ± 0.48 N/kg) compared with HER (d = −2.3), HEXT (d = −1.3), and HAB (d = −1.7; all P values ≤ .001), and correlations were small to moderate (r = 0.236–0.310, R2 = 0.06–0.10). Conclusions Strength in WB positions was different than strength evaluated using traditional NWB assessments in female athletes. Weight-bearing tests may provide clinicians with additional information regarding strength and function.

scholarly journals Isokinetic strength of shoulder internal and external rotators in cricket bowlers

2002 ◽  
Vol 58 (2) ◽  
Author(s):  
X.M. Mabasa ◽  
A. Stewart ◽  
C. Fleishman
Keyword(s):  
External Rotation ◽  
Peak Torque ◽  
Isokinetic Strength ◽  
Neutral Position ◽  
Joint System ◽  
Rotational Strength ◽  
Significant Difference ◽  
Position Data ◽  
Torque Values ◽  
Rotation Strength

The strength of the shoulder internal and external rotators incricket bowlers, may not be sufficient to cope with the demands of bowling.As very little research has been done on cricketers, this study was done to establish the isokinetic strength profile of the shoulder internal andexternal rotators in cricket bowlers.Isokinetic, shoulder rotational strength was evaluated in thirty malecricket volunteers with a mean age of 23.9 years and mean body weight of 70.3 kgs. The Cybex 340 dynamometer multi joint system was used to collect data on shoulder rotation strength in a standing neutral position. Data were collected at four different speeds (60,90,180 and 300deg/sec) and were computed for peak torque values for internal and external ratios for both dominant and non dominant shoulders.The results showed no statistically significant difference in the mean shoulder rotational torque between the bowlingand non-bowling shoulders for external rotation (p>0.05), and indicated statistically significant differences in themean shoulder rotational torque between the bowling and non-bowling shoulders for internal rotation (p<0.05). Therewas a significant decrease in isokinetic peak torque production for the external/internal rotator muscles as the speedof contraction increased (p<0.05). The peak torque ratio for the external/internal rotator muscles of the bowling armwere significantly less than of the non-bowling arm (p<0.05). These findings suggest that the strength ratios of thebowling arm need to be considered when managing young cricketers and their injuries.

The Relationship Between Hip Strength and the Y Balance Test

2018 ◽  
Vol 27 (5) ◽  
pp. 445-450 ◽  
Author(s):  
Benjamin R. Wilson ◽  
Kaley E. Robertson ◽  
Jeremy M. Burnham ◽  
Michael C. Yonz ◽  
Mary Lloyd Ireland ◽  
...  
Keyword(s):  
Linear Regression ◽  
Test Performance ◽  
External Rotation ◽  
Linear Regression Analysis ◽  
Balance Performance ◽  
Balance Test ◽  
Hip Strength ◽  
Hip Abduction ◽  
The Relationship ◽  
Abduction Strength

Context: The Y Balance Test was developed as a test of dynamic postural control and has been shown to be predictive of lower-extremity injury. However, the relationship between hip strength and performance on the Y Balance Test has not been fully elucidated. Objective: The goal of this study was to identify the relationship between components of isometric hip strength and the Y Balance Test, to provide clinicians better guidance as to specific areas of muscle performance to address in the event of poor performance on the Y Balance Test. Design: Laboratory study. Setting: Biomechanics laboratory. Participants: A total of 73 healthy participants (40 males and 33 females) volunteered for this study. Intervention: None. Main Outcome Measures: Participants completed the Y Balance Test on the right leg. The authors then measured peak isometric torque in hip external rotation, abduction, and extension. Correlations were calculated between torque measurements, normalized for mass and Y Balance Test performance. Significant relationships were used in linear regression models to determine which variables were predictive of the Y Balance Test performance. Results: The authors found significant positive correlations between Y Balance Test performance and hip abduction strength. They also found correlations between the Y Balance Test and hip extension and external rotation strengths. Linear regression analysis showed hip abduction to be the only significant predictor of Y Balance performance. Conclusions: The authors found the strongest association between the Y Balance Test and hip abduction strength. They also showed smaller but significant associations with hip extension and external rotation strength. When entered into a linear regression analysis, hip abduction strength was the only significant predictor of Y Balance performance. Using this information, practitioners should look to hip abduction strength when patients exhibit deficits in the Y Balance Test.

scholarly journals Eccentric Hip Muscle Function in Females With and Without Patellofemoral Pain Syndrome

2009 ◽  
Vol 44 (5) ◽  
pp. 490-496 ◽  
Author(s):  
Rodrigo de Marche Baldon ◽  
Theresa Helissa Nakagawa ◽  
Thiago Batista Muniz ◽  
César Ferreira Amorim ◽  
Carlos Dias Maciel ◽  
...  
Keyword(s):  
Muscle Function ◽  
External Rotation ◽  
Pain Syndrome ◽  
Peak Torque ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Control Group ◽  
Hip Muscle ◽  
Hip Abduction ◽  
Torque Values

Abstract Context: Patellofemoral pain syndrome (PFPS) is a common knee condition in athletes. Recently, researchers have indicated that factors proximal to the knee, including hip muscle weakness and motor control impairment, contribute to the development of PFPS. However, no investigators have evaluated eccentric hip muscle function in people with PFPS. Objective: To compare the eccentric hip muscle function between females with PFPS and a female control group. Design: Cross-sectional study. Setting: Musculoskeletal laboratory. Patients or Other Participants: Two groups of females were studied: a group with PFPS (n  =  10) and a group with no history of lower extremity injury or surgery (n  =  10). Intervention(s): Eccentric torque of the hip musculature was evaluated on an isokinetic dynamometer. Main Outcome Measure(s): Eccentric hip abduction, adduction, and external and internal rotation peak torque were measured and expressed as a percentage of body mass (Nm/kg × 100). We also evaluated eccentric hip adduction to abduction and internal to external rotation torque ratios. The peak torque value of 5 maximal eccentric contractions was used for calculation. Two-tailed, independent-samples t tests were used to compare torque results between groups. Results: Participants with PFPS exhibited much lower eccentric hip abduction (t18  =  −2.917, P  =  .008) and adduction (t18  =  −2.764, P  =  .009) peak torque values than did their healthy counterparts. No differences in eccentric hip external (t18  =  0.45, P  =  .96) or internal (t18  =  −0.742, P  =  .47) rotation peak torque values were detected between the groups. The eccentric hip adduction to abduction torque ratio was much higher in the PFPS group than in the control group (t18  =  2.113, P  =  .04), but we found no difference in the eccentric hip internal to external rotation torque ratios between the 2 groups (t18  =  −0.932, P  =  .36). Conclusions: Participants with PFPS demonstrated lower eccentric hip abduction and adduction peak torque and higher eccentric adduction to abduction torque ratios when compared with control participants. Thus, clinicians should consider eccentric hip abduction strengthening exercises when developing rehabilitation programs for females with PFPS.

scholarly journals Reliability of Measurement of Glenohumeral Internal Rotation, External Rotation, and Total Arc of Motion in 3 Test Positions

2014 ◽  
Vol 49 (5) ◽  
pp. 640-646 ◽  
Author(s):  
Mark A. Kevern ◽  
Michael Beecher ◽  
Smita Rao
Keyword(s):  
Internal Rotation ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Interrater Reliability ◽  
External Rotation ◽  
Intraclass Correlation ◽  
Test Procedure ◽  
Intrarater Reliability ◽  
Testing Procedures ◽  
Test Position

Context: Athletes who participate in throwing and racket sports consistently demonstrate adaptive changes in glenohumeral-joint internal and external rotation in the dominant arm. Measurements of these motions have demonstrated excellent intrarater and poor interrater reliability. Objective: To determine intrarater reliability, interrater reliability, and standard error of measurement for shoulder internal rotation, external rotation, and total arc of motion using an inclinometer in 3 testing procedures in National Collegiate Athletic Association Division I baseball and softball athletes. Design: Cross-sectional study. Setting: Athletic department. Patients or Other Participants Thirty-eight players participated in the study. Shoulder internal rotation, external rotation, and total arc of motion were measured by 2 investigators in 3 test positions. The standard supine position was compared with a side-lying test position, as well as a supine test position without examiner overpressure. Results: Excellent intrarater reliability was noted for all 3 test positions and ranges of motion, with intraclass correlation coefficient values ranging from 0.93 to 0.99. Results for interrater reliability were less favorable. Reliability for internal rotation was highest in the side-lying position (0.68) and reliability for external rotation and total arc was highest in the supine-without-overpressure position (0.774 and 0.713, respectively). The supine-with-overpressure position yielded the lowest interrater reliability results in all positions. The side-lying position had the most consistent results, with very little variation among intraclass correlation coefficient values for the various test positions. Conclusions: The results of our study clearly indicate that the side-lying test procedure is of equal or greater value than the traditional supine-with-overpressure method.

Measurement of Ankle Dorsiflexion: A Comparison of Active and Passive Techniques in Multiple Positions

2011 ◽  
Vol 20 (3) ◽  
pp. 333-344 ◽  
Author(s):  
David A. Krause ◽  
Beth A. Cloud ◽  
Lindsey A. Forster ◽  
Jennifer A. Schrank ◽  
John H. Hollman
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Interrater Reliability ◽  
Emg Activity ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Intrarater Reliability ◽  
Significant Difference ◽  
Anterior Tibialis ◽  
Passive Techniques

Context:Limited ankle DF (DF) range of motion (ROM) resulting from restricted gastrocnemius and soleus mobility is associated with a variety of lower extremity pathologies. Several techniques are used clinically to measure ankle DF.Objectives:To evaluate the reliability and minimal detectable change of DF ROM measurement, determine whether there is a difference in measured DF between techniques, and quantify the electromyographic (EMG) activity of the soleus and tibialis anterior muscles associated with the techniques.Design:Repeated measures.Setting:Controlled laboratory setting.Participants:39 healthy subjects, age 22–33.Main Outcome Measures:DF measurements using 5 different techniques including active and passive DF with the knee extended and flexed to 90° and a modified lunge. EMG activity of the soleus and anterior tibialis muscles.Results:Intrarater reliability values (ICC3,1) ranged from .68 to .89. Interrater reliability (ICC2,1) ranged from .55 to .82. ICCs were the greatest with the modified lunge. The minimal detectable change (MDC95) ranged from 6° to 8° among the different techniques. A significant difference in DF ROM was found between all methods. Measurements taken with active DF were greater than the same measures taken passively. The lunge position resulted in greater DF ROM than both active and passive techniques. EMG activity of the soleus was greater with active DF and the lunge than with passive DF.Conclusions:The modified lunge, which demonstrated excellent intrarater and interrater reliability, may best represent maximal DF. Active end-range DF was significantly greater than passive end-range DF when measured at either 0° or 90° knee flexion. Greater active DF was not explained by inhibition of the soleus. Finally, using the modified lunge, a difference between 2 measurements over time of 6° or more suggests that a meaningful change has occurred.

scholarly journals Normative measures of hip strength and relation to previous injury in collegiate cross-country runners

2021 ◽  
Author(s):  
C. Nathan Vannatta ◽  
Thomas W. Kernozek
Keyword(s):  
External Rotation ◽  
Ncaa Division Iii ◽  
Normative Values ◽  
Division Iii ◽  
Cross Sectional ◽  
Hip Strength ◽  
Previous Injury ◽  
Hip Abduction ◽  
Cross Country ◽  
Cross Country Runners

Abstract Context: Running related injury occurs frequently in collegiate cross-country runners. Hip strength is one factor that may be important in the rehabilitation and training of cross-country runners. However, no normative values exist to inform these strategies. Objective: Establish normative values for hip abduction and external rotation isometric strength in collegiate cross-country runners and explore the association between strength and previous injury. Design: Mixed methods using descriptive epidemiology and retrospective cross-sectional designs. Setting: University Laboratory Patients or Other Participants: Eighty-two NCAA Division III cross-country runners (38 males, 44 females) participated in this study. Main Outcome Measure(s): Isometric hip strength and reported injury Results: Males demonstrated greater absolute hip strength than females. Measures of hip strength were not different between sexes when normalized to height and mass. Hip abduction asymmetry was associated with previous injury in males. A combination of at least one leg with hip abduction weakness and bilateral external rotation weakness was associated with previous injury in females. Conclusions: Knowledge of normative values of hip strength may help inform rehabilitation strategies in collegiate cross-country runners. Males and females may demonstrate differing strength profiles following running related injury.

Quantification of Anterior Translation of the Humeral Head in the Throwing Shoulder

2000 ◽  
Vol 28 (2) ◽  
pp. 161-167 ◽  
Author(s):  
Todd S. Ellenbecker ◽  
Angelo J. Mattalino ◽  
Eric Elam ◽  
Roger Caplinger
Keyword(s):  
Clinical Evaluation ◽  
Humeral Head ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Professional Baseball ◽  
Intrarater Reliability ◽  
Stress Radiography ◽  
Significant Difference ◽  
Baseball Pitchers ◽  
Head Translation

Clinical evaluation of humeral head translation relies mainly on manual tests to measure laxity in the human shoulder. The purposes of this study were to determine whether side-to-side differences exist in anterior humeral head translation in professional baseball pitchers, to compare manual laxity testing with stress radiography for quantifying humeral head translation, and to test intrarater reliability of the manual humeral head translation and stress radiography tests. Twenty professional baseball pitchers underwent bilateral manual anterior humeral head translation and stress radiographic tests. Stress radiography was performed by imparting a 15-daN anterior load to the shoulder in 90° of abduction with both neutral and 60° of external rotation and recording the glenohumeral joint translation at rest and under stress in each position. Eight subjects were retested to assess the reliability of these methods. Results showed no significant difference between the dominant and nondominant extremity in the amount of anterior humeral head translation measured manually and with stress radiography, nor significant correlation between anterior humeral head translation measured manually and by stress radiography. Testretest reliability was moderate-to-poor for the manual humeral head translation test and moderate for stress radiography.

scholarly journals Interrater and intrarater reliability of the Knosp scale for pituitary adenoma grading

2017 ◽  
Vol 126 (5) ◽  
pp. 1714-1719 ◽  
Author(s):  
Michael A. Mooney ◽  
Douglas A. Hardesty ◽  
John P. Sheehy ◽  
Robert Bird ◽  
Kristina Chapple ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Interrater Reliability ◽  
Pituitary Surgery ◽  
Full Scale ◽  
Intrarater Reliability ◽  
Percent Agreement ◽  
Significant Difference ◽  
Mri Scans ◽  
Grading Scale ◽  
Common Clinical Practice

OBJECTIVEThe goal of this study was to determine the interrater and intrarater reliability of the Knosp grading scale for predicting pituitary adenoma cavernous sinus (CS) involvement.METHODSSix independent raters (3 neurosurgery residents, 2 pituitary surgeons, and 1 neuroradiologist) participated in the study. Each rater scored 50 unique pituitary MRI scans (with contrast) of biopsy-proven pituitary adenoma. Reliabilities for the full scale were determined 3 ways: 1) using all 50 scans, 2) using scans with midrange scores versus end scores, and 3) using a dichotomized scale that reflects common clinical practice. The performance of resident raters was compared with that of faculty raters to assess the influence of training level on reliability.RESULTSOverall, the interrater reliability of the Knosp scale was “strong” (0.73, 95% CI 0.56–0.84). However, the percent agreement for all 6 reviewers was only 10% (26% for faculty members, 30% for residents). The reliability of the middle scores (i.e., average rated Knosp Grades 1 and 2) was “very weak” (0.18, 95% CI −0.27 to 0.56) and the percent agreement for all reviewers was only 5%. When the scale was dichotomized into tumors unlikely to have intraoperative CS involvement (Grades 0, 1, and 2) and those likely to have CS involvement (Grades 3 and 4), the reliability was “strong” (0.60, 95% CI 0.39–0.75) and the percent agreement for all raters improved to 60%. There was no significant difference in reliability between residents and faculty (residents 0.72, 95% CI 0.55–0.83 vs faculty 0.73, 95% CI 0.56–0.84). Intrarater reliability was moderate to strong and increased with the level of experience.CONCLUSIONSAlthough these findings suggest that the Knosp grading scale has acceptable interrater reliability overall, it raises important questions about the “very weak” reliability of the scale's middle grades. By dichotomizing the scale into clinically useful groups, the authors were able to address the poor reliability and percent agreement of the intermediate grades and to isolate the most important grades for use in surgical decision making (Grades 3 and 4). Authors of future pituitary surgery studies should consider reporting Knosp grades as dichotomized results rather than as the full scale to optimize the reliability of the scale.

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