title: Reproducibility of hand-held ankle dynamometry to measure altered ankle moment-angle characteristics in children with spastic cerebral palsy.
abstract: BACKGROUND
  In children with spastic cerebral palsy, the range of motion of the ankle joint is often limited. Measurement of range of motion may be hampered by a non-rigid foot deformity. We constructed a hand-held instrument which allows measurements of static ankle angle and moment in children with cerebral palsy while correcting for foot deformity. This study aimed to test the reproducibility of the instrument and to use it for measuring ankle moment-angle characteristics in individual children who are typically developing and children with cerebral palsy.
  
  
  METHODS
  Ankle angles and moments were measured at five standardized positions in ten children who are typically developing and ten children with cerebral palsy. The intraclass correlation coefficient was calculated for test-retest reliability. For precision, the standard error of measurement and smallest detectable difference were determined. The ankle range of motion and the slope of the moment-angle curve were determined, both towards plantar flexion and dorsiflexion.
  
  
  RESULTS
  The reproducibility study revealed a high reliability of the dynamometer at 5 repetitions (>0.97). Precision lies within 5 degrees for angle measurements and within 0.2 Nm for moment measurements. In the children with cerebral palsy, the range of motion towards dorsiflexion was 18 degrees lower and the slope of the moment-angle curve towards dorsiflexion was substantially higher.
  
  
  CONCLUSIONS
  We developed a hand-held dynamometer which allows reliable and precise measurements of static ankle angle and moment in children with cerebral palsy. The hand-held dynamometer allows corrections of foot deformities and is qualified to reproducibly evaluate moment-angle characteristics in a clinical context.
authors.affiliation: Research Institute Move, Faculty of Human Movement Sciences, VU University, Amsterdam, The Netherlands. m.benard@fbw.vu.nl
authors.forename: Menno R
authors.initials: MR
authors.lastname: Bénard
authors.forename: Richard T
authors.initials: RT
authors.lastname: Jaspers
authors.forename: Peter A
authors.initials: PA
authors.lastname: Huijing
authors.forename: Jules G
authors.initials: JG
authors.lastname: Becher
authors.forename: Jaap
authors.initials: J
authors.lastname: Harlaar
mesh_terms: D000843:Ankle Joint / Q000503:physiopathology*; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology*; D002648:Child; D005260:Female; D005531:Foot Deformities, Acquired / Q000150:complications / Q000503:physiopathology; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000503:physiopathology; D053581:Muscle Strength Dynamometer; D016059:Range of Motion, Articular; D015203:Reproducibility of Results