Larson Daniel, Lorenz Daniel, Melton Brittany
Physical Therapy, OrthoKansas/Lawrence Memorial Hospital.
School of Pharmacy, University of Kansas.
Int J Sports Phys Ther. 2022 Oct 1;17(6):1095-1103. doi: 10.26603/001c.37907. eCollection 2022.
Assessment of knee flexion torque is a relevant clinical measure following various injuries and surgeries to determine progress in rehabilitation and inform decision making. A variety of methods using hand-held dynamometry have been shown to be reliable in obtaining this measure, and typically require a means of external fixation or stabilization. Clinically efficient methods of reliable clinician-stabilization are sparse in the literature.
HYPOTHESIS/PURPOSE: Determine inter and intra-rater reliability of two clinically efficient methods of assessing isometric knee flexion torque using hand-held dynamometry with clinician-stabilization. The hypothesis was that each method would yield good to excellent reliability.
Cross-Sectional Study.
Twenty healthy individuals were assessed by two clinicians on two separate days. During each session, knee flexion torque was assessed with hand-held dynamometry with two methods: 1) in the seated position with the hip and knee flexed to 90 degrees while the clinician stabilized the dynamometer between the participant's leg and table and 2) in prone with the hip at 0 degrees and knee at 90 degrees while the clinician assumed a stride stance with elbows locked in extension to stabilize the dynamometer on the participant's leg. Inter and intra-rater reliability were determined for each method.
ICC values were 0.88-0.94 and 0.77-0.90 for inter and intra-rater reliability respectively with the seated method. The prone method yielded ICC values of 0.84-0.96 and 0.89-0.94 for inter and intra-rater reliability respectively. MDC values ranged from 30-62% with the seated method and 21-40% with the prone method.
Inter and intra-rater reliability were good to excellent for assessing knee flexion torque with hand-held dynamometry using both the seated and prone methods with clinically efficient clinician-stabilization approaches. The prone method may be more sensitive to detecting change over time due to lower MDC values.
2b.
评估膝关节屈曲扭矩是各类损伤和手术后的一项重要临床指标，用于确定康复进展并为决策提供依据。已证明多种使用手持测力计的方法在获取该指标时具有可靠性，且通常需要外部固定或稳定装置。文献中临床高效的可靠临床医生稳定方法较为稀少。
假设/目的：确定两种使用手持测力计并由临床医生稳定的临床高效评估等长膝关节屈曲扭矩方法的评分者间和评分者内信度。假设是每种方法都将产生良好至优秀的信度。
横断面研究。
20名健康个体由两名临床医生在两个不同日期进行评估。在每次评估期间，使用两种方法通过手持测力计评估膝关节屈曲扭矩：1）坐姿，髋部和膝关节屈曲至90度，临床医生将测力计稳定在参与者腿部和桌子之间；2）俯卧位，髋部处于0度，膝关节处于90度，临床医生采取大步站立姿势，肘部伸直锁定，将测力计稳定在参与者腿部。确定每种方法的评分者间和评分者内信度。
坐姿法的评分者间和评分者内信度的组内相关系数（ICC）值分别为0.88 - 0.94和0.77 - 0.90。俯卧位法的评分者间和评分者内信度的ICC值分别为0.84 - 0.96和0.89 - 0.94。最小可检测变化（MDC）值在坐姿法中为30% - 62%，在俯卧位法中为21% - 40%。
使用坐姿和俯卧位方法并采用临床高效的临床医生稳定方法，通过手持测力计评估膝关节屈曲扭矩时，评分者间和评分者内信度良好至优秀。由于MDC值较低，俯卧位法可能对检测随时间的变化更敏感。
2b。
