Hand-held Dynamometry: Difference between revisions
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* The average and individual trial numbers should both be reported | * The average and individual trial numbers should both be reported | ||
** Common units: pounds (lbs), Newtons (N), or kilogram-force (kgf) | ** Common units: pounds (lbs), Newtons (N), or kilogram-force (kgf) | ||
** Can be expressed as a percentage of the unaffected extremity (e.g., R knee extension 90% of L knee extension) | ** Can be expressed as a percentage of the unaffected/less impaired extremity (e.g., R knee extension 90% of L knee extension) | ||
The following video demonstrates the use of a hand-held dynamometer in various positions: <ref>HOGGANScientific. Handheld Dynamometry with HOGGAN Scientific’s microFET2. Available from: https://www.youtube.com/watch?v=8G2x1VYsFGU [last accessed 2/29/2024]. </ref> | |||
{{#ev:youtube|8G2x1VYsFGU}} | |||
=== Benefits === | === Benefits === | ||
* Decreased subjective interpretation (compared to manual muscle testing grades beyond a 3/5) | * Decreased subjective interpretation (compared to manual muscle testing grades beyond a 3/5) | ||
* Reliable, objective testing of muscle strength | * Reliable, objective [[Muscle Strength Testing|testing of muscle strength]] | ||
* Not gravity-dependent in its interpretation | * Not gravity-dependent in its interpretation | ||
* Minimizes the tester's contribution to error (make test principle) | * Minimizes the tester's contribution to error (make test principle) | ||
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* No present universal, standardized positions | * No present universal, standardized positions | ||
* Questionable inter-tester reliability | * Questionable inter-tester reliability (related to lack of standardized positions) | ||
* Error if subject strength greater than tester (concentric contraction) | * Error if subject strength greater than tester (concentric contraction) | ||
** Important for tester to ensure good body mechanics for maximum efficiency | ** Important for tester to ensure good body mechanics for maximum efficiency | ||
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==Evidence== | ==Evidence== | ||
* In healthy adults aged 20-53 years of age, HHD demonstrated weak-to-moderate concurrent validity (''r'' value 0.37-0.51, ''p''≤0.05) with the "gold standard" measure of muscle strength assessment, isokinetic dynamometry (IKD) for peak torque values in hip extension <ref>Keep H, Luu L, Berson A, Garland SJ. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4961312/#B29 Validity of the Handheld Dynamometer Compared with an Isokinetic Dynamometer in Measuring Peak Hip Extension Strength.] Physiother Can. 2016;68(1):15-22.</ref> | |||
* The American Academy of Physical Medicine and Rehabilitation published a systematic review which supports the use of HHD as a reliable and valid measure of muscle strength that is easy to use, portable, and more cost-affordable than IKD, but does question its efficacy for larger joint use such as the knee <ref>Stark T, Walker B, Phillips JK, Fejer R, Beck R. [https://www.researchgate.net/publication/51124614_Hand-held_Dynamometry_Correlation_With_the_Gold_Standard_Isokinetic_Dynamometry_A_Systematic_Review Hand-held dynamometry correlation with the gold standard isokinetic dynamometry: a systematic review.] PM R. 2011;3(5):472-9.</ref> | |||
* The ActivForce Digital Dynamometer and microFET2 HHDs were found to have similar levels of intra- and inter-tester reliability and criterion validity for assessing shoulder muscle force production of internal rotation, external rotation, and forward elevation. Reported intraclass correlation (ICC) values for intra- and inter-rater reliability were high (0.85-0.99) <ref>Karagiannopoulos C, Griech S, Leggin B. Reliability and Validity of the ActivForce Digital Dynamometer in Assessing Shoulder Muscle Force across Different User Experience Levels. Int J Sports Phys Ther. 2022;17(4):669-676.</ref> | |||
* A proposed HHD measurement of 31.1% knee extension force (normalized to bodyweight) was established as necessary for independence in performing a sit to stand in hospitalized adult populations <ref>Eriksrud O, Bohannon RW. [https://academic.oup.com/ptj/article/83/6/544/2805277 Relationship of knee extension force to independence in sit-to-stand performance in patients receiving acute rehabilitation.] Phys Ther. 2003;83(6):544-51.</ref> | |||
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==Resources== | ==Resources== | ||
Revision as of 21:55, 29 February 2024
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Purpose[edit | edit source]
Handheld Dynamometry (HHD) is a method utilized to assess muscle strength. Although other dynamometers were utilized to assess grip strength, this version of a dynamometer is set up or held by the therapist to derive an objective measurement of force.
Procedure[edit | edit source]
Unlike traditional manual muscle testing as a "break test," the preferred method for HHD is to utilize a "make test" format. This assessment requires the subject to exert a maximum isometric force while the dynamometer is held stationary. [1]
An example procedure is as follows (however, there is some variety in procedures performed; it is important to clearly document the procedure and positioning utilized to ensure consistency and reproducibility):
- The examiner keeps the dynamometer stable
- The patient/client/subject produces maximal force against the instrument while the examiner matches this force
- Verbal commands provided include "push as hard as possible," and "push, push, push, push"
- Each trial is performed over a 3-4 second hold, with 2-3 trials being performed
- The average and individual trial numbers should both be reported
- Common units: pounds (lbs), Newtons (N), or kilogram-force (kgf)
- Can be expressed as a percentage of the unaffected/less impaired extremity (e.g., R knee extension 90% of L knee extension)
The following video demonstrates the use of a hand-held dynamometer in various positions: [2]
Benefits[edit | edit source]
- Decreased subjective interpretation (compared to manual muscle testing grades beyond a 3/5)
- Reliable, objective testing of muscle strength
- Not gravity-dependent in its interpretation
- Minimizes the tester's contribution to error (make test principle)
Drawbacks[edit | edit source]
- No present universal, standardized positions
- Questionable inter-tester reliability (related to lack of standardized positions)
- Error if subject strength greater than tester (concentric contraction)
- Important for tester to ensure good body mechanics for maximum efficiency
Evidence[edit | edit source]
- In healthy adults aged 20-53 years of age, HHD demonstrated weak-to-moderate concurrent validity (r value 0.37-0.51, p≤0.05) with the "gold standard" measure of muscle strength assessment, isokinetic dynamometry (IKD) for peak torque values in hip extension [3]
- The American Academy of Physical Medicine and Rehabilitation published a systematic review which supports the use of HHD as a reliable and valid measure of muscle strength that is easy to use, portable, and more cost-affordable than IKD, but does question its efficacy for larger joint use such as the knee [4]
- The ActivForce Digital Dynamometer and microFET2 HHDs were found to have similar levels of intra- and inter-tester reliability and criterion validity for assessing shoulder muscle force production of internal rotation, external rotation, and forward elevation. Reported intraclass correlation (ICC) values for intra- and inter-rater reliability were high (0.85-0.99) [5]
- A proposed HHD measurement of 31.1% knee extension force (normalized to bodyweight) was established as necessary for independence in performing a sit to stand in hospitalized adult populations [6]
Resources[edit | edit source]
add any relevant resources here
References[edit | edit source]
- ↑ Bohannon RW. Make tests and break tests of elbow flexor muscle strength. Phys Ther. 1988 Feb;68(2):193-4.
- ↑ HOGGANScientific. Handheld Dynamometry with HOGGAN Scientific’s microFET2. Available from: https://www.youtube.com/watch?v=8G2x1VYsFGU [last accessed 2/29/2024].
- ↑ Keep H, Luu L, Berson A, Garland SJ. Validity of the Handheld Dynamometer Compared with an Isokinetic Dynamometer in Measuring Peak Hip Extension Strength. Physiother Can. 2016;68(1):15-22.
- ↑ Stark T, Walker B, Phillips JK, Fejer R, Beck R. Hand-held dynamometry correlation with the gold standard isokinetic dynamometry: a systematic review. PM R. 2011;3(5):472-9.
- ↑ Karagiannopoulos C, Griech S, Leggin B. Reliability and Validity of the ActivForce Digital Dynamometer in Assessing Shoulder Muscle Force across Different User Experience Levels. Int J Sports Phys Ther. 2022;17(4):669-676.
- ↑ Eriksrud O, Bohannon RW. Relationship of knee extension force to independence in sit-to-stand performance in patients receiving acute rehabilitation. Phys Ther. 2003;83(6):544-51.
