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Agreement between isokinetic dynamometer and hand-held isometric dynamometer as measures to detect lower limb asymmetry in muscle torque after anterior cruciate ligament reconstruction
Department of Health Sciences, Lund University, Lund, Sweden.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Department of Health Sciences, Lund University, Lund, Sweden.ORCID iD: 0000-0002-3282-6320
2022 (English)In: International Journal of Sports Physical Therapy, E-ISSN 2159-2896, Vol. 17, no 7, p. 1307-1317Article in journal (Refereed) Published
Abstract [en]

Background: Two commonly used instruments to assess muscle strength after anterior cruciate ligament reconstruction are the isokinetic dynamometer, which measures isokinetic torque and the hand-held dynamometer, which measures isometric torque. Isokinetic dynamometers are considered superior to other instruments but may not be commonly used in clinical settings. Hand-held dynamometers are small, portable, and more clinically applicable devices.

Purpose: The purpose of this study was to assess agreement between a hand-held dynamometer and an isokinetic dynamometer, used to assess lower limb symmetry in knee muscle torque one year after anterior cruciate ligament (ACL) reconstruction.

Study design: Cross-sectional measurement study

Methods: Seventy-two participants who had undergone ACL reconstruction (35 men, 37 women; age= 25.8 ± 5.4 years) were included. Isokinetic muscle torque in knee flexion and extension was measured with an isokinetic dynamometer. Isometric flexion and extension knee muscle torque was measured with a hand-held dynamometer. Bland & Altman plots and Cohen’s Kappa coefficient were used to assess agreement between measurements obtained from the instruments.

Result: Bland & Altman plots showed wide limits of agreement between the instruments for both flexion and extension limb symmetry index. Cohen´s Kappa coefficient revealed a poor to slight agreement between the extension limb symmetry index values (0.136) and a fair agreement for flexion limb symmetry index values (0.236). Cross-tabulations showed that the hand-held dynamometer detected a significantly larger number of participants with abnormal flexion torque limb symmetry index compared to the isokinetic dynamometer.

Conclusion: The wide limits of agreements and Cohen’s Kappa coefficients values revealed insufficient agreement between the measurements taken with the two instruments, indicating that the instruments should not be used interchangeably. The hand-held dynamometer was more sensitive in detecting abnormal limb symmetry index in flexion torque, which promotes the option of use of hand-held dynamometers to detect differences between the injured and uninjured leg after ACL reconstruction.

Level of evidence: 3b

Place, publisher, year, edition, pages
2022. Vol. 17, no 7, p. 1307-1317
National Category
Physiotherapy Surgery Occupational Therapy
Research subject
physiotherapy
Identifiers
URN: urn:nbn:se:umu:diva-201491DOI: 10.26603/001c.39798ISI: 000918842700012Scopus ID: 2-s2.0-85143218143OAI: oai:DiVA.org:umu-201491DiVA, id: diva2:1716041
Available from: 2022-12-05 Created: 2022-12-05 Last updated: 2023-09-05Bibliographically approved

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Cronström, Anna

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CiteExportLink to record
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Citation style
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