title: Reliability of muscle strength assessment in chronic post-stroke hemiparesis: a systematic review and meta-analysis.
abstract: BACKGROUND
  Muscle weakness is the main cause of motor impairment among stroke survivors and is associated with reduced peak muscle torque.
  
  
  OBJECTIVE
  To systematically investigate and organize the evidence of the reliability of muscle strength evaluation measures in post-stroke survivors with chronic hemiparesis.
  
  
  METHODS
  Two assessors independently searched four electronic databases in January 2014 (Medline, Scielo, CINAHL, Embase).
  
  
  METHODS
  Inclusion criteria comprised studies on reliability on muscle strength assessment in adult post-stroke patients with chronic hemiparesis.
  
  
  METHODS
  We extracted outcomes from included studies about reliability data, measured by intraclass correlation coefficient (ICC) and/or similar. The meta-analyses were conducted only with isokinetic data.
  
  
  RESULTS
  Of 450 articles, eight articles were included for this review. After quality analysis, two studies were considered of high quality. Five different joints were analyzed within the included studies (knee, hip, ankle, shoulder, and elbow). Their reliability results varying from low to very high reliability (ICCs from 0.48 to 0.99). Results of meta-analysis for knee extension varying from high to very high reliability (pooled ICCs from 0.89 to 0.97), for knee flexion varying from high to very high reliability (pooled ICCs from 0.84 to 0.91) and for ankle plantar flexion showed high reliability (pooled ICC = 0.85).
  
  
  CONCLUSIONS
  Objective muscle strength assessment can be reliably used in lower and upper extremities in post-stroke patients with chronic hemiparesis.
authors.affiliation: College of Ceilândia, University of Brasília , Brasília, Brazil.
authors.forename: Michelle
authors.initials: M
authors.lastname: Rabelo
authors.forename: Guilherme S
authors.initials: GS
authors.lastname: Nunes
authors.forename: Natália Menezes
authors.initials: NM
authors.lastname: da Costa Amante
authors.forename: Marcos
authors.initials: M
authors.lastname: de Noronha
authors.forename: Emerson
authors.identifier: 0000-0001-9858-9009
authors.initials: E
authors.lastname: Fachin-Martins
mesh_terms: D005080:Exercise Test / Q000592:standards*; D006801:Humans; D053580:Muscle Strength / Q000502:physiology*; D010291:Paresis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D015203:Reproducibility of Results; D020521:Stroke / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology
keywords: Intraclass correlation coefficient; Isokinetic dynamometer; Knee; Strength; Stroke