title: Enhancing the examiner's resisting force improves the reliability of manual muscle strength measurements: comparison of a new device with hand-held dynamometry.
abstract: OBJECTIVE
  To develop and determine the reliability of a newly -designed resistance-enhanced dynamometer for muscle strength measurement, and to test the hypothesis that enhancing the examiner's resisting force improves the reliability of manual muscle strength measurements.
  
  
  METHODS
  An intra-examiner, inter-examiner, intra-session and inter-session reliability study.
  
  
  METHODS
  Twenty-five men (mean age 22.5 (standard deviation (SD) 1.7) years) were tested separately by 2 examiners using the resistance-enhanced dynamometer and a traditional hand-held dynamometer for an intra- and inter-examiner reliability study. Twenty-seven volunteers (mean age 22.1 (SD 0.8) years) were tested by a female examiner using the resistance-enhanced dynamometer for an intra- and inter-session reliability study.
  
  
  METHODS
  Maximum resisting forces for the knee flexors and extensors were measured using the resistance-enhanced dynamometer and the traditional hand-held dynamometer.
  
  
  RESULTS
  The traditional hand-held dynamometer had good intra-examiner reliability (intra-class correlation coefficient (ICC) = 0.79-0.93) but poor inter-examiner reliability (ICC = 0.11-0.28). The resistance-enhanced dynamo meter had very good intra-examiner (ICC = 0.91-0.94), inter-examiner (ICC = 0.98), intra-session (ICC = 0.93-0.99) and inter-session (ICC = 0.91-0.92) reliability. The resistance-enhanced dynamometer also had better inter-examiner agreement (smallest real difference (SRD) 9-16% for resistance-enhanced dynamometer, 21-43% for traditional hand-held dynamometer).
  
  
  CONCLUSIONS
  The resistance-enhanced dynamometer had very good reliability. Enhancing the examiner's resisting force appeared to improve the reliability of manual muscle strength measurements. The resistance-enhanced dynamometer is useful for muscle strength measurements in clinical practice.
authors.affiliation: Institute of Biomedical Engineering, National Taiwan University, No. 1, Sec. 1, Jen-Ai Road, Taipei, Taiwan. twlu@ntu.edu.tw
authors.forename: Tung-Wu
authors.initials: TW
authors.lastname: Lu
authors.forename: Horng-Chaung
authors.initials: HC
authors.lastname: Hsu
authors.forename: Ling-Ying
authors.initials: LY
authors.lastname: Chang
authors.forename: Hao-Ling
authors.initials: HL
authors.lastname: Chen
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology; D008297:Male; D053580:Muscle Strength; D053581:Muscle Strength Dynamometer; D018482:Muscle, Skeletal / Q000502:physiology; D015588:Observer Variation; D015203:Reproducibility of Results