Axelsson Peter, Kärrholm Johan
Department of Hand Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
J Hand Surg Am. 2018 Sep;43(9):865.e1-865.e10. doi: 10.1016/j.jhsa.2018.01.009. Epub 2018 Feb 14.
To determine the repeatability and validity of new methods designed to objectively measure forearm torque and lifting strength in a clinical setting.
Twenty-eight healthy volunteers, 19 women and 9 men, were tested for lifting strength and forearm torque with the Kern and Baseline dynamometers. Two raters tested each participant on 3 occasions in the standing position. One of the raters also examined 15 subjects, 3 times, for forearm torque in the seated position and for lifting strength and forearm torque by the Work Simulator II, Baltimore Therapeutic Equipment (BTE II). Intraclass correlation coefficients (ICC) model 2,1 was used to calculate ICCs for intra- and interrater reliability. The same ICC model and Bland-Altman plots were used to analyze the validity and agreement between the new test methods and the BTE II equipment and for comparison between tests performed in the standing and seated positions.
Intra- and interrater reliability for forearm torque measurements with both the Baseline and the BTE II demonstrated ICCs between 0.88 and 0.96. The comparison between the Baseline and the BTE equipment yielded lower ICCs of 0.74 to 0.88 but they were still substantial and in good agreement. The ICCs for torques recorded in the standing and seated position were 0.89 to 0.96. Lifting strength, measured in 3 different positions of forearm rotation, yielded ICC values between 0.84 and 0.96 for both raters and with both the Kern and the BTE II instruments. Similarly, comparisons between the Kern and the BTE II methods showed ICC values between 0.91 and 0.95.
Both the Baseline and the Kern dynamometers demonstrated excellent intra- and interrater repeatability. Except for forearm torque test in direction of pronation, which had a slightly lower ICC of 0.74, our new methods were valid when the BTE II was used as the reference standard. Assessments in the standing or seated position for torque measurements made little difference. Thus, we found the quality of measurements performed with our new methods sufficient for future studies of forearm torque and lifting strength.
Simple, yet reliable, methods to quantify torque and lifting strength in a clinical setting have the potential to improve evaluations of wrist and forearm disorders as well as their treatments.
确定旨在在临床环境中客观测量前臂扭矩和举力的新方法的可重复性和有效性。
28名健康志愿者，19名女性和9名男性，使用克恩测力计和基线测力计测试举力和前臂扭矩。两名评估者在站立位对每位参与者进行3次测试。其中一名评估者还对15名受试者进行了3次测试，测试其坐位时的前臂扭矩以及使用巴尔的摩治疗设备工作模拟器II（BTE II）测试举力和前臂扭矩。使用组内相关系数（ICC）模型2,1计算评估者内和评估者间可靠性的ICC。使用相同的ICC模型和布兰德-奥特曼图分析新测试方法与BTE II设备之间的有效性和一致性，以及站立位和坐位测试之间的比较。
使用基线测力计和BTE II进行前臂扭矩测量的评估者内和评估者间可靠性显示ICC在0.88至0.96之间。基线测力计和BTE设备之间的比较得出较低的ICC，为0.74至0.88，但它们仍然很高且一致性良好。站立位和坐位记录的扭矩的ICC为0.89至0.96。在3个不同的前臂旋转位置测量的举力，两名评估者使用克恩测力计和BTE II仪器得出的ICC值均在0.84至0.96之间。同样，克恩测力计和BTE II方法之间的比较显示ICC值在0.91至0.95之间。
基线测力计和克恩测力计均显示出出色的评估者内和评估者间可重复性。除了旋前方向的前臂扭矩测试ICC略低，为0.74外，当以BTE II作为参考标准时，我们的新方法是有效的。站立位或坐位进行扭矩测量的评估差异不大。因此，我们发现使用我们的新方法进行测量的质量足以用于未来前臂扭矩和举力的研究。
在临床环境中量化扭矩和举力的简单但可靠的方法有可能改善手腕和前臂疾病及其治疗的评估。
