The Interrater Reliability of Hand-held Dynamometry Estimates of Isometric
Knee Extensor and Flexor Muscle Force.
Jessica C. Dunn, MS, PT1,3 Maura D. Iversen, PT, MPH, SD2,3,4
1 Eliot health care Center
2 Department of Physical Therapy, Graduate School for Health Sciences,
Simmons College
3 RBB Multipurpose Arthritis & Musculoskeletal Diseases Center,
Department of Medicine, Division of Rheumatology, Immunology and Allergy,
Brigham & Women’s Hospital
4 Harvard Medical School, Boston, MA
Objective
To determine the interrater reliability of the Nicholas Manual Muscle
Tester (NMMT) in assessing knee muscle force. Methods. Twenty-five subjects,
17 females (68%) and 8 males (32%) (x age = 68.2 years ± 7.5),
with degenerative back pain for > 6 months participated. Two female
physical therapists assessed subjects’ isometric knee extensor
and flexor muscle force. Knee position was standardized between measures
and raters. Order of testing was performed at random. Intraclass correlation
coefficients (ICC) were used to assess the interrater reliability in
the total sample and among subjects classified into subgroups according
to the Lumbar Spinal Stenosis-symptom severity scale as having high
or low symptoms. A Fisher’s z-test was performed to test the association
between raters’ scores in each subgroup. Results. Interrater reliability
was high for the total sample (0.87-0.93) and subgroups (high symptom
[0.89-0.95]; low symptom [0.80-0.90]). There was no significant difference
in raters’ reliability between subgroups (z= 1.54; p=0.12).
Conclusions
HHD is a reliable, quantitative tool for assessing lower extremity muscle
force in older adults with low back symptoms.
This study was supported in part by grants from the Physical Therapy
Foundation (MDI) and Arthritis Foundation (MDI).
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