title: Lower Extremity Handheld Dynamometry Strength Measurement in Children With Cerebral Palsy.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the evidence on reliability of handheld dynamometry protocols to quantify maximal isometric strength of the muscles of the lower extremities of children with cerebral palsy.
  
  
  METHODS
  A systematic search of Cochrane, MEDLINE, CINAHL, and PubMed up to December 2013 and best-evidence synthesis were performed.
  
  
  RESULTS
  Seven eligible studies were identified. Best-evidence synthesis revealed "unknown" to "moderate" evidence. Intraclass correlation coefficient values were "positive" for most muscle groups for intrarater reliability and showed mixed results for interrater reliability.
  
  
  CONCLUSIONS
  Because of small sample sizes (10-25) in all included studies, the final level of evidence remains "unknown." Reliability data obtained in the included studies of handheld dynamometry in children with cerebral palsy are promising, despite low levels of evidence. When these protocols are applied very carefully, they may prove relevant to different clinical settings.
authors.affiliation: University for Professionals in Pediatric Physical Therapy (Ms Mulder-Brouwer and Dr Rameckers), AVANSplus, Breda, the Netherlands; Medicort, Centre for Physiotherapy (Ms Mulder-Brouwer), Utrecht, the Netherlands; Department of Rehabilitation Medicine (Dr Rameckers), CAPHRI, Maastricht University, and Centre of Expertise, Adelante Valkenburg, the Netherlands; Department of Epidemiology (Dr Bastiaenen, Dr Rameckers), Research Group Function and Rehabilitation CAPHRI, Maastricht University, Maastricht, the Netherlands.
authors.forename: Angelique N
authors.initials: AN
authors.lastname: Mulder-Brouwer
authors.forename: Eugene A A
authors.initials: EA
authors.lastname: Rameckers
authors.forename: Caroline H
authors.initials: CH
authors.lastname: Bastiaenen
mesh_terms: D002547:Cerebral Palsy / Q000503:physiopathology* / Q000534:rehabilitation*; D002648:Child; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology; D035002:Lower Extremity / Q000503:physiopathology*; D053580:Muscle Strength / Q000502:physiology*; D053581:Muscle Strength Dynamometer; D015203:Reproducibility of Results