title: Reliability of the Q Force; a mobile instrument for measuring isometric quadriceps muscle strength.
abstract: BACKGROUND
  The ability to generate muscle strength is a pre-requisite for all human movement. Decreased quadriceps muscle strength is frequently observed in older adults and is associated with a decreased performance and activity limitations. To quantify the quadriceps muscle strength and to monitor changes over time, instruments and procedures with a sufficient reliability are needed. The Q Force is an innovative mobile muscle strength measurement instrument suitable to measure in various degrees of extension. Measurements between 110 and 130° extension present the highest values and the most significant increase after training. The objective of this study is to determine the test-retest reliability of muscle strength measurements by the Q Force in older adults in 110° extension.
  
  
  METHODS
  Forty-one healthy older adults, 13 males and 28 females were included in the study. Mean (SD) age was 81.9 (4.89) years. Isometric muscle strength of the Quadriceps muscle was assessed with the Q Force at 110° of knee extension. Participants were measured at two sessions with a three to eight day interval between sessions. To determine relative reliability, the intraclass correlation coefficient (ICC) was calculated. To determine absolute reliability, Bland and Altman Limits of Agreement (LOA) were calculated and t-tests were performed.
  
  
  RESULTS
  Relative reliability of the Q Force is good to excellent as all ICC coefficients are higher than 0.75. Generally a large 95 % LOA, reflecting only moderate absolute reliability, is found as exemplified for the peak torque left leg of -18.6 N to 33.8 N and the right leg of -9.2 N to 26.4 N was between 15.7 and 23.6 Newton representing 25.2 % to 39.9 % of the size of the mean. Small systematic differences in mean were found between measurement session 1 and 2.
  
  
  CONCLUSIONS
  The present study shows that the Q Force has excellent relative test-retest reliability, but limited absolute test-retest reliability. Since the Q Force is relatively cheap and mobile it is suitable for application in various clinical settings, however, its capability to detect changes in muscle force over time is limited but comparable to existing instruments.
authors.affiliation: Research and Innovation Group in Healthy Aging, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands ; Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: K W
authors.initials: KW
authors.lastname: Douma
authors.affiliation: University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences Groningen, Groningen, The Netherlands.
authors.forename: G R H
authors.initials: GR
authors.lastname: Regterschot
authors.affiliation: Research and Innovation Group in Healthy Aging, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands.
authors.forename: W P
authors.initials: WP
authors.lastname: Krijnen
authors.affiliation: School of Health Care Studies Hanze University of Applied Science Groningen, Groningen, The Netherlands.
authors.forename: G E C
authors.initials: GE
authors.lastname: Slager
authors.affiliation: Research and Innovation Group in Healthy Aging, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, Groningen, The Netherlands ; Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: C P
authors.initials: CP
authors.lastname: van der Schans
authors.affiliation: Institute of Movement and Sport Gerontology, German Sport University, Cologne, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Zijlstra
keywords: Elderly; Isometric muscle strength; Q force; Quadriceps