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Kate Anne McGirr, Thomas Kennedy, Carsten M. Mølgaard and Michael Skovdal Rathleff

Context:

Measurement of ankle evertor and invertor strength is important for assessment of ankle sprain risk and assessment of restoration of normal function after an ankle sprain.

Objective:

To compare the intra-tester reliability of ankle evertor and invertor strength measurements derived from hand-held dynamometry (HHD) and strap-mounted dynamometry (SMD) for both make-test and break-test techniques.

Participants:

25 healthy individuals.

Main Outcome Measure:

Repeated measurements of isometric evertor and invertor strength derived from both HHD and SMD devices using both make-test and break-test techniques.

Results:

High make-test reliability values were found for both inversion and eversion force measured by both the HHD and SMD devices (ICC = 0.80 to ICC = 0.88). The correlation coeffcients between HHD and SMD measurements for the inversion make-test, the inversion break-test, and the eversion make-test ranged from r = 0.74 to r = 0.87, but the correlation between HHD and SMD measurements for the eversion break-test was poor.

Conclusion:

The fndings suggest that testers with limited experience can obtain reliable measurements of ankle evertor and invertor strength using either HHD or SMD.

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Luke Van Wyk, Gwendolen Jull, Bill Vicenzino, Mathew Greaves and Shaun O’Leary

The purpose of this study was to compare maximal torque exerted about the craniocervical (CC) and cervicothoracic (CT) axes in the sagittal plane using a novel dynamometry device. Maximal voluntary contraction (MVC) recordings in newton-meters (N·m) were measured in 20 males and 20 females for each of 4 tests: CT extension, CT flexion, CC extension, CC flexion. Twenty of the volunteers repeated the testing procedure on a second occasion to determine the test–retest repeatability of the measures. MVC recordings at the CT axis (extension, 30.24 ± 12.15 N·m; flexion, 18.90 ± 8.21 N⋅m) were 1.4–2 times greater than recordings at the CC axis (extension, 16.46 ± 7.26 N⋅m; fexion, 13.34 ± 5.97 N·m). Extensor to flexor strength ratios reduced from 1.75 at the CT axis to 1.24 at the CC axis, but were similar for both males and females. Good to excellent test–retest repeatability was demonstrated for all tests (ICC = 0.75–0.99, SEM = 0.50–2.44 N·m). Consistent with differences in the muscle morphology at the CC and CT axes, torque exerted about these axes differ. Separate measurement of torque about these axes potentially offers a more comprehensive profile of cervical muscle strength.

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Derya Celik, Ahmet Dirican and Gul Baltaci

Context: Handheld dynamometry (HHD) is considered an objective method of measuring strength, but the reliability of the procedure can be compromised by inadequate tester strength and insufficient stabilization of the dynamometer especially, for the scapular muscles. Objective: Primarily, to determine the intrarater reliability of HHD when testing shoulder and scapular muscle strength, and secondarily, to report reliability when corrected for body-mass index (BMI). Design: Technical report. Setting: University physiotherapy department. Participants: 57 adults (17 men, 40 women; mean age = 35.05 ± 13.5 y), both healthy individuals and patients with shoulder impingement. Intervention: HHD. Main Outcome Variables: Muscle strength of the upper, middle, and lower trapezius; anterior deltoid; serratus anterior; supraspinatus; and latissimus dorsi determined by HHD. Each muscle was assessed 3 times, and the mean value was calculated. The subjects were divided into 3 groups according to BMI. Group 1: BMI ≤ 20 kg/m2 (n = 22); Group 2: BMI ≤ 24.9 kg/m2 (n = 54); and Group 3: BMI ≤ 29.9 kg/m2 (n = 38). Results: Correlations were calculated for each pair of strength scores. Intraclass correlation coefficients (ICCs) ranged from .77 to .99 in healthy subjects and from .75 to .99 in patients, for all muscle groups except the upper trapezius (P < .05). Reliability values ranged from good to high in healthy subjects but were less consistent for the upper trapezius (ICC .45-.65). The relationship with BMI and muscle strength illustrates that as BMI increases, there is a decrease in reliability values of the lower trapezius (ICC = .35-.65). Conclusion: The study demonstrates that evaluating the strength of scapular and shoulder muscles using HHD presents reliable results for both patients with impingement syndrome and healthy subjects. Reliability values were compressed when testing the trapezius in subjects with higher BMI. This is likely a result of the examiner's difficulty in overcoming the patients with this maneuver.

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Brent M. Kelln, Patrick O. McKeon, Lauren M. Gontkof and Jay Hertel

Context:

Hand-held dynamometry (HHD) has been shown to be a reliable, objective way to obtain strength measurements in elderly and physically impaired subjects.

Objective:

To estimate the intratester, intertester, and intersession reliability of HHD testing of lower extremity movements in young, healthy subjects.

Design:

Repeated measures.

Setting:

Sports medicine laboratory.

Participants:

Nine males and eleven females (Mean age = 26 years).

Measurements:

Strength measures of 11 right lower extremity movements were taken by 3 different testers on 2 separate days using a HHD.

Results:

Intratester ICC range was .77 to .97 with SEM range of .01 to .44 kg. Mean intertester ICC range was .65 to .87 with SEM range of .11 to 1.05 kg. Mean intersession ICC range was .62 to .92 with SEM range of .01 to .83 kg.

Conclusions:

HHD has the potential to be a reliable tool for strength measurements in healthy, strong subjects; however, there are noteworthy limitations with movements where subjects can overpower the testers.

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Bram L. Newman, Courtney L. Pollock and Michael A. Hunt

Context: Lateral trunk-flexion strength is an important determinant of overall trunk stability and function, but the reliability in measuring this outcome clinically in athletic individuals is not known. Objective: To determine the interrater and intrarater reliability of lateral trunk-flexion strength measurement in athletic individuals using handheld dynamometry. Design: Reliability study. Setting: Research laboratory. Participants: 12 healthy, athletic individuals. Intervention: Lateral trunk-flexion strength was measured using handheld dynamometry across 2 different trunk placements (lateral aspect of the axilla and laterally at the level of the midtrunk) and 2 testing occasions by 2 therapists. Three maximum-effort trials during a "make test" at each placement were completed for each therapist on both occasions. Main Outcome Measures: Maximum force output was identified and converted to a torque. Intraclass correlation coefficients (ICC2,1) were calculated for each dynamometer placement, therapist, and test occasion to determine intrarater and interrater reliability. Results: Intrarater reliability was moderate to good (ICC2,1 = .53-.77), while interrater reliability was good to very good (ICC2,1 = .79-81) at the axilla position. For the midtrunk position, intrarater reliability was good to very good (ICC2,1 = .80-.86), while interrater reliability was good on both days (ICC2,1 = .87-.88). Finally, the standard errors of measurement were low for the axilla position (0.20 Nm/kg; 95% CI .15, .28) and midtrunk position (0.09 Nm/kg; 95% CI .07, .12). Conclusions: Maximum lateral trunk-flexion strength can be reliably measured in athletic individuals with greater overall strength. Based on the 2 positions used in this study, measurement with a dynamometer placement at the midtrunk may be more reliable than that obtained at the axilla.

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Shaun O’Leary, Carlijn Hoogma, Øystein Molland Solberg, Sara Sundberg, Ashley Pedler and Luke Van Wyk

regions. 24 – 27 A novel dynamometry method was previously described, differentially recording isometric cervical flexor and extensor muscle performance about representative axes in the craniocervical and cervicothoracic regions of the neck in the sagittal plane. 28 , 29 This method accounted for some

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Joseph B. Lesnak, Dillon T. Anderson, Brooke E. Farmer, Dimitrios Katsavelis and Terry L. Grindstaff

dynamometry, field-based measurements, and thigh girth have been utilized in the estimation of quadriceps strength. 14 – 16 Although rating of perceived exertion is a relatively easy metric to determine following injury, it has poor agreement with 1RM loads obtained during a knee extensor exercise. 15 Other

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Bryan L. Riemann and George J. Davies

orthopedic patient populations. 4 While most isokinetic testing involves an isolated open kinetic chain joint test, a reliable UE push–pull isokinetic method also exists. 5 Given the relative movement pattern similarity between the push–pull test with the SSASP, and because isokinetic dynamometry provides

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Scott R. Brown, Matt Brughelli and Lee A. Bridgeman

Context:

Muscle imbalances aid in the identification of athletes at risk for lower-extremity injury. Little is known regarding the influence that leg preference or playing position may have on lower-extremity muscle strength and asymmetry.

Purpose:

To investigate lower-extremity strength profiles in rugby union athletes and compare isokinetic knee- and hip-strength variables between legs and positions.

Methods:

Thirty male academy rugby union athletes, separated into forwards (n = 15) and backs (n = 15), participated in this cross-sectional analysis. Isokinetic dynamometry was used to evaluate peak torque, angle of peak torque, and strength ratios of the preferred and nonpreferred legs during seated knee extension/flexion and supine hip extension/flexion at 60°/s.

Results:

Backs were older (ES = 1.6) but smaller in stature (ES = –0.47) and body mass (ES = –1.3) than the forwards. The nonpreferred leg was weaker than the preferred leg for forwards during extension (ES = –0.37) and flexion (ES = –0.21) actions and for backs during extension (ES = –0.28) actions. Backs were weaker at the knee than forwards in the preferred leg during extension (ES = –0.50) and flexion (ES = –0.66) actions. No differences were observed in strength ratios between legs or positions. Backs produced peak torque at longer muscle lengths in both legs at the knee (ES = –0.93 to –0.94) and hip (ES = –0.84 to –1.17) than the forwards.

Conclusions:

In this sample of male academy rugby union athletes, the preferred leg and forwards displayed superior strength compared with the nonpreferred leg and backs. These findings highlight the importance of individualized athletic assessments to detect crucial strength differences in male rugby union athletes.

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Scott R. Brown, Matt Brughelli, Peter C. Griffiths and John B. Cronin

Purpose:

While several studies have documented isokinetic knee strength in junior and senior rugby league players, investigations of isokinetic knee and hip strength in professional rugby union players are limited. The purpose of this study was to provide lower-extremity strength profiles and compare isokinetic knee and hip strength of professional rugby league and rugby union players.

Participants:

32 professional rugby league and 25 professional rugby union players.

Methods:

Cross-sectional analysis. Isokinetic dynamometry was used to evaluate peak torque and strength ratios of the dominant and nondominant legs during seated knee-extension/flexion and supine hip-extension/flexion actions at 60°/s.

Results:

Forwards from both codes were taller and heavier and had a higher body-mass index than the backs of each code. Rugby union forwards produced significantly (P < .05) greater peak torque during knee flexion in the dominant and nondominant legs (ES = 1.81 and 2.02) compared with rugby league forwards. Rugby league backs produced significantly greater hip-extension peak torque in the dominant and nondominant legs (ES = 0.83 and 0.77) compared with rugby union backs. There were no significant differences in hamstring-to-quadriceps ratios between code, position, or leg. Rugby union forwards and backs produced significantly greater knee-flexion-to-hip-extension ratios in the dominant and nondominant legs (ES = 1.49–2.26) than rugby union players.

Conclusions:

It seems that the joint torque profiles of players from rugby league and union codes differ, which may be attributed to the different demands of each code.