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Abstract
Objective: To investigate the within-session reliability and test–re-test reliability of hand-held dynamometry (HHD) to quantify strength in hip flexors, quadriceps, plantarflexors and triceps brachii following traumatic brain injury (TBI).
Design: Within-session reliability was examined across six consecutive trials of HHD. Test–re-test reliability was examined between two sessions separated by 7 days.
Setting: Private physical therapy practice, Melbourne, Australia.
Participants: Ten adults with TBI with a mean age of 32.5 years (range = 19–63, SD = 12.8) and mean time after injury of 12.2 years (range = 2.3–26, SD = 8.6).
Main outcome measures: Isometric strength measured by HHD.
Results: Test–re-test reliability of HHD following TBI was good when repeated tests occurred within a single session. Within a session, the first trial was the most variable out of the six examined. Of the four muscles examined, re-test measures of strength for the quadriceps, plantarflexors and triceps were the most reliable. For the hip flexors an increase greater than 3.1 kg (28%) was needed before real change could be detected. Test–re-test reliability was higher for muscles tested on the more affected side (ICC(2,1)= 0.55–0.93) than muscles tested on the less affected side (ICC(2,1)= 0.09–0.86).
Conclusions: To gain a representative measure of isometric strength using HHD in a single session, three trials are recommended. The first is for familiarization and trials 2 and 3 are averaged to provide a typical measure of isometric muscle strength. Further research needs to occur but alternative methods to quantify muscle strength might be needed if repeated measures are to be performed over a 7-day interval.