Concurrent Validity of Lower Limb Muscle Strength by Handheld Dynamometry in Children 7 to 11 Years Old

in Journal of Sport Rehabilitation

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Ryan MahaffeySchool of Sport, Health and Applied Sciences, St Mary’s University, Twickenham, United Kingdom

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Megan Le WarneSchool of Sport, Health and Applied Sciences, St Mary’s University, Twickenham, United Kingdom

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Stewart C. MorrisonSchool of Life Course and Population Sciences, King’s College London, London, United Kingdom

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Wendy I. DrechslerSchool of Population Health and Environmental Sciences, King’s College London, London, United Kingdom

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Nicola TheisSchool of Sport and Exercise, University of Gloucestershire, Gloucester, United Kingdom

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Context: The assessment of pediatric muscle strength is necessary in a range of applications, including rehabilitation programs. Handheld dynamometry (HHD) is considered easy to use, portable, and low cost, but validity to measure lower limb muscle strength in children has not been assessed. Objective: To determine the concurrent validity of lower limb torque from HHD compared with isokinetic dynamometry (ID) in children aged from 7 to 11 years old. Design: A descriptive assessment of concurrent validity of lower limb joint torques from HHD compared with ID. Methods: Sixty-one typically developing children underwent assessment of maximal hip, knee, and ankle isometric torque by HHD and ID using standardized protocols. Joint positions were selected to represent maximal strength and were replicated between devices. Concurrent validity was determined by Pearson correlation, limits of agreement, and Bland–Altman plots. Results: Correlations between HHD and ID were moderate to large for knee extension (r 95% CI, .39 to .73), small to large for plantar flexion (r 95% CI, .29 to .67), knee flexion (r 95% CI, .16 to .59), hip flexion (r 95% CI, .21 to .57), hip extension (r 95% CI, .18 to .54), and hip adduction (r 95% CI, .12 to .56), and small to moderate for dorsiflexion (r 95% CI, −.11 to .39) and hip abduction (r 95% CI, −.02 to .46). Limits of agreement for all joint torques were greater than 10% indicating large error in HHD measured torque compared with ID. A positive proportional bias was detected for plantarflexion, indicating that HHD underestimated torque to a greater extent in participants with higher torque values. Conclusions: Maximal torque values from HHD and ID are consistent with those previously reported in the literature. Poor concurrent validity of HHD may have arisen from issues around joint position, joint stabilization, and the experience of the tester to prevent an isokinetic contraction. Pediatric lower limb muscle strength assessed by HHD should be interpreted with caution.

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