Clinical assessment of hip strength using a hand-held dynamometer is reliable
Hip strength assessment plays an important role in the clinical examination of the hip and groin region. The primary aim of this study was to examine the absolute test–retest measurement variation concerning standardized strength assessments of hip abduction (ABD), adduction (ADD), external rotation...
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| Published in | Scandinavian journal of medicine & science in sports Vol. 20; no. 3; pp. 493 - 501 |
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| Main Authors | , , , |
| Format | Journal Article |
| Language | English |
| Published |
Oxford, UK
Blackwell Publishing Ltd
01.06.2010
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| Subjects | |
| Online Access | Get full text |
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| Abstract | Hip strength assessment plays an important role in the clinical examination of the hip and groin region. The primary aim of this study was to examine the absolute test–retest measurement variation concerning standardized strength assessments of hip abduction (ABD), adduction (ADD), external rotation (ER), internal rotation (IR), flexion (FLEX) and extension (EXT) using a hand‐held dynamometer. Nine subjects (five males, four females), physically active for at least 2.5 h a week, were included. Twelve standardized isometric strength tests were performed twice with a 1‐week interval in between by the same examiner. The test order was randomized to avoid systematic bias. Measurement variation between sessions was 3–12%. When the maximum value of four measurements was used, test–retest measurement variation was below 10% in 11 of the 12 individual hip strength tests and below 5% in five of the 12 tests. No systematic differences were present. Standardized strength assessment procedures of hip ABD, ER, IR, FLEX, with test–retest measurement variation below 5%, hip ADD below 6% and hip EXT below 8%, make it possible to determine even small changes in hip strength at the individual level. |
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| AbstractList | Hip strength assessment plays an important role in the clinical examination of the hip and groin region. The primary aim of this study was to examine the absolute test-retest measurement variation concerning standardized strength assessments of hip abduction (ABD), adduction (ADD), external rotation (ER), internal rotation (IR), flexion (FLEX) and extension (EXT) using a hand-held dynamometer. Nine subjects (five males, four females), physically active for at least 2.5 h a week, were included. Twelve standardized isometric strength tests were performed twice with a 1-week interval in between by the same examiner. The test order was randomized to avoid systematic bias. Measurement variation between sessions was 3-12%. When the maximum value of four measurements was used, test-retest measurement variation was below 10% in 11 of the 12 individual hip strength tests and below 5% in five of the 12 tests. No systematic differences were present. Standardized strength assessment procedures of hip ABD, ER, IR, FLEX, with test-retest measurement variation below 5%, hip ADD below 6% and hip EXT below 8%, make it possible to determine even small changes in hip strength at the individual level.Hip strength assessment plays an important role in the clinical examination of the hip and groin region. The primary aim of this study was to examine the absolute test-retest measurement variation concerning standardized strength assessments of hip abduction (ABD), adduction (ADD), external rotation (ER), internal rotation (IR), flexion (FLEX) and extension (EXT) using a hand-held dynamometer. Nine subjects (five males, four females), physically active for at least 2.5 h a week, were included. Twelve standardized isometric strength tests were performed twice with a 1-week interval in between by the same examiner. The test order was randomized to avoid systematic bias. Measurement variation between sessions was 3-12%. When the maximum value of four measurements was used, test-retest measurement variation was below 10% in 11 of the 12 individual hip strength tests and below 5% in five of the 12 tests. No systematic differences were present. Standardized strength assessment procedures of hip ABD, ER, IR, FLEX, with test-retest measurement variation below 5%, hip ADD below 6% and hip EXT below 8%, make it possible to determine even small changes in hip strength at the individual level. Hip strength assessment plays an important role in the clinical examination of the hip and groin region. The primary aim of this study was to examine the absolute test-retest measurement variation concerning standardized strength assessments of hip abduction (ABD), adduction (ADD), external rotation (ER), internal rotation (IR), flexion (FLEX) and extension (EXT) using a hand-held dynamometer. Nine subjects (five males, four females), physically active for at least 2.5 h a week, were included. Twelve standardized isometric strength tests were performed twice with a 1-week interval in between by the same examiner. The test order was randomized to avoid systematic bias. Measurement variation between sessions was 3-12%. When the maximum value of four measurements was used, test-retest measurement variation was below 10% in 11 of the 12 individual hip strength tests and below 5% in five of the 12 tests. No systematic differences were present. Standardized strength assessment procedures of hip ABD, ER, IR, FLEX, with test-retest measurement variation below 5%, hip ADD below 6% and hip EXT below 8%, make it possible to determine even small changes in hip strength at the individual level. Hip strength assessment plays an important role in the clinical examination of the hip and groin region. The primary aim of this study was to examine the absolute test-retest measurement variation concerning standardized strength assessments of hip abduction (ABD), adduction (ADD), external rotation (ER), internal rotation (IR), flexion (FLEX) and extension (EXT) using a hand-held dynamometer. Nine subjects (five males, four females), physically active for at least 2.5 h a week, were included. Twelve standardized isometric strength tests were performed twice with a 1-week interval in between by the same examiner. The test order was randomized to avoid systematic bias. Measurement variation between sessions was 3-12%. When the maximum value of four measurements was used, test-retest measurement variation was below 10% in 11 of the 12 individual hip strength tests and below 5% in five of the 12 tests. No systematic differences were present. Standardized strength assessment procedures of hip ABD, ER, IR, FLEX, with test-retest measurement variation below 5%, hip ADD below 6% and hip EXT below 8%, make it possible to determine even small changes in hip strength at the individual level. [PUBLICATION ABSTRACT] |
| Author | Hölmich, P. Thorborg, K. Petersen, J. Magnusson, S. P. |
| Author_xml | – sequence: 1 givenname: K. surname: Thorborg fullname: Thorborg, K. organization: Department of Orthopaedic Surgery, Amager Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark – sequence: 2 givenname: J. surname: Petersen fullname: Petersen, J. organization: Department of Orthopaedic Surgery, Amager Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark – sequence: 3 givenname: S. P. surname: Magnusson fullname: Magnusson, S. P. organization: Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark – sequence: 4 givenname: P. surname: Hölmich fullname: Hölmich, P. organization: Department of Orthopaedic Surgery, Amager Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/19558384$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1249/mss.0b013e3180601109 10.1177/036354659001800403 10.1097/00042752-200501000-00004 10.1177/0363546505281808 10.1093/ptj/68.2.193 10.1097/00042752-199904000-00007 10.1177/03635465010290020301 10.1016/j.jelekin.2008.07.005 10.1016/j.apmr.2007.10.028 10.1682/JRRD.2005.11.0172 10.1080/00401706.1969.10490657 10.1016/j.apmr.2006.09.011 10.1519/15184.1 10.1016/j.apmr.2003.07.013 10.2519/jospt.2003.33.11.671 10.1177/036354659202000604 10.1136/bjsm.2002.003483 |
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| References | Kelln BM, Mckeon PO, Gontkof LM, Hertel J. Hand-held dynamometry: reliability of lower extremity muscle testing in healthy, physically active, young adults. J Sport Rehabil 2008: 17: 160-170. Cichanowski HR, Schmitt JS, Johnson RJ, Niemuth PE. Hip strength in collegiate female athletes with patellofemoral pain. Med Sci Sports Exerc 2007: 39: 1227-1232. Tyler TF, Nicholas SJ, Mullaney MJ, Mchugh MR. The role of hip muscle function in the treatment of patellofemoral pain syndrome. Am J Sports Med 2006: 34: 630-636. Emery CA, Maitland ME, Meeuwisse WH. Test-retest reliability of isokinetic hip adductor and flexor muscle strength. Clin J Sport Med 1999: 9: 79-85. Grubbs F. Procedures for detecting outlying observations in samples. Technometrics 1969: 11: 1-21. Claiborne TL, Timmons MK, Pincivero DM. Test-retest reliability of cardinal plane isokinetic hip torque and EMG. J Electromyogr Kinesiol 2009 (in press). Cetin C, Sekir U, Yildiz Y, Aydin T, Ors F, Kalyon TA. Chronic groin pain in an amateur soccer player. Br J Sports Med 2004: 38: 223-224. Bohannon RW. Make tests and break tests of elbow flexor muscle strength. Phys Ther 1988: 68: 193-194. Sisto SA, Dyson-Hudson T. Dynamometry testing in spinal cord injury. J Rehabil Res Dev 2007: 44: 123-136. Holmich P, Holmich LR, Bjerg AM. Clinical examination of athletes with groin pain: an intraobserver and interobserver reliability study. Br J Sports Med 2004: 38: 446-451. Click FP, Bellew JW, Pitts TA, Kay RE. Reliability of stabilised commercial dynamometers for measuring hip abduction strength: a pilot study. Br J Sports Med 2003: 37: 331-334. Niemuth PE, Johnson RJ, Myers MJ, Thieman TJ. Hip muscle weakness and overuse injuries in recreational runners. Clin J Sport Med 2005: 15: 14-21. Tyler TF, Nicholas SJ, Campbell RJ, Mchugh MP. The association of hip strength and flexibility with the incidence of adductor muscle strains in professional ice hockey players. Am J Sports Med 2001: 29: 124-128. Agre JC, Magness JL, Hull SZ, Wright KC, Baxter TL, Patterson R, Stradel L. Strength testing with a portable dynamometer: reliability for upper and lower extremities. Arch Phys Med Rehabil 1987: 68: 454-458. Pua YH, Wrigley TW, Cowan SM, Bennell KL. Intrarater test-retest reliability of hip range of motion and hip muscle strength measurements in persons with hip osteoarthritis. Arch Phys Med Rehabil 2008: 89: 1146-1154. Weir JP. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res 2005: 19: 231-240. Kendall FP, McCreary EK, Provance PG. Muscles testing and function. Baltimore: Williams and Wilkins, 1993. Arokoski MH, Arokoski JPA, Haara M, Kankaanpaa M, Vesterinen M, Niemitukia LH, Helminen HJ. Hip muscle strength and muscle cross sectional area in men with and without hip osteoarthritis. J Rheumatol 2002: 29: 2185-2195. Krause DA, Schlagel SJ, Stember BM, Zoetewey JE, Hollman JH. Influence of lever arm and stabilization on measures of hip abduction and adduction torque obtained by hand-held dynamometry. Arch Phys Med Rehabil 2007: 88: 37-42. O'Connor DM. Groin injuries in professional rugby league players: a prospective study. J Sports Sci 2004: 22: 629-636. Akermark C, Johansson C. Tenotomy of the adductor Longus Tendon in the treatment of chronic groin pain in athletes. Am J Sports Med 1992: 20: 640-643. Holmich P, Uhrskou P, Ulnits L, Kanstrup IL, Nielsen MB, Bjerg AM, Krogsgaard K. Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. Lancet 1999: 353: 439-443. Ireland ML, Willson JD, Ballantyne BT, Davis IM. Hip strength in females with and without patellofemoral pain. J Orthop and Sports Phys Ther 2003: 33: 671-676. Scott DA, Bond EQ, Sisto SA, Nadler SF. The intra- and interrater reliability of hip muscle strength assessments using a handheld versus a portable dynamometer anchoring station. Arch Phys Med Rehabil 2004: 85: 598-603. Magnusson SP, Gleim GW, Nicholas JA. Subject variability of shoulder abduction strength testing. Am J Sports Med 1990: 18: 349-353. Lu TW, Hsu HC, Chang LY, Chen HL. Enhancing the examiner's resisting force improves the reliability of manual muscle strength measurements: comparison of a new device with hand-held dynamometry. J Rehabil Med 2007: 39: 679-684. 1987; 68 2007; 39 2004; 22 2004; 85 2005; 19 2002; 29 2006; 34 2004; 38 1990; 18 2008; 17 2009 1969; 11 2003; 37 2008; 89 1988; 68 1993 1999; 353 2001; 29 1992; 20 2005; 15 2007; 88 2007; 44 2003; 33 1999; 9 e_1_2_7_6_1 e_1_2_7_5_1 e_1_2_7_3_1 e_1_2_7_8_1 e_1_2_7_7_1 e_1_2_7_19_1 e_1_2_7_17_1 e_1_2_7_14_1 e_1_2_7_11_1 e_1_2_7_10_1 Kendall FP (e_1_2_7_16_1) 1993 e_1_2_7_26_1 e_1_2_7_27_1 Holmich P (e_1_2_7_13_1) 1999; 353 Agre JC (e_1_2_7_2_1) 1987; 68 Click FP (e_1_2_7_9_1) 2003; 37 e_1_2_7_25_1 e_1_2_7_24_1 Kelln BM (e_1_2_7_15_1) 2008; 17 e_1_2_7_23_1 e_1_2_7_22_1 O'Connor DM. (e_1_2_7_21_1) 2004; 22 e_1_2_7_20_1 Holmich P (e_1_2_7_12_1) 2004; 38 Lu TW (e_1_2_7_18_1) 2007; 39 Arokoski MH (e_1_2_7_4_1) 2002; 29 |
| References_xml | – reference: Agre JC, Magness JL, Hull SZ, Wright KC, Baxter TL, Patterson R, Stradel L. Strength testing with a portable dynamometer: reliability for upper and lower extremities. Arch Phys Med Rehabil 1987: 68: 454-458. – reference: Emery CA, Maitland ME, Meeuwisse WH. Test-retest reliability of isokinetic hip adductor and flexor muscle strength. Clin J Sport Med 1999: 9: 79-85. – reference: Holmich P, Holmich LR, Bjerg AM. Clinical examination of athletes with groin pain: an intraobserver and interobserver reliability study. Br J Sports Med 2004: 38: 446-451. – reference: Grubbs F. Procedures for detecting outlying observations in samples. Technometrics 1969: 11: 1-21. – reference: Kendall FP, McCreary EK, Provance PG. Muscles testing and function. Baltimore: Williams and Wilkins, 1993. – reference: Holmich P, Uhrskou P, Ulnits L, Kanstrup IL, Nielsen MB, Bjerg AM, Krogsgaard K. Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. Lancet 1999: 353: 439-443. – reference: Claiborne TL, Timmons MK, Pincivero DM. Test-retest reliability of cardinal plane isokinetic hip torque and EMG. J Electromyogr Kinesiol 2009 (in press). – reference: Magnusson SP, Gleim GW, Nicholas JA. Subject variability of shoulder abduction strength testing. Am J Sports Med 1990: 18: 349-353. – reference: Sisto SA, Dyson-Hudson T. Dynamometry testing in spinal cord injury. J Rehabil Res Dev 2007: 44: 123-136. – reference: Niemuth PE, Johnson RJ, Myers MJ, Thieman TJ. Hip muscle weakness and overuse injuries in recreational runners. Clin J Sport Med 2005: 15: 14-21. – reference: Scott DA, Bond EQ, Sisto SA, Nadler SF. The intra- and interrater reliability of hip muscle strength assessments using a handheld versus a portable dynamometer anchoring station. Arch Phys Med Rehabil 2004: 85: 598-603. – reference: Krause DA, Schlagel SJ, Stember BM, Zoetewey JE, Hollman JH. Influence of lever arm and stabilization on measures of hip abduction and adduction torque obtained by hand-held dynamometry. Arch Phys Med Rehabil 2007: 88: 37-42. – reference: O'Connor DM. Groin injuries in professional rugby league players: a prospective study. J Sports Sci 2004: 22: 629-636. – reference: Pua YH, Wrigley TW, Cowan SM, Bennell KL. Intrarater test-retest reliability of hip range of motion and hip muscle strength measurements in persons with hip osteoarthritis. Arch Phys Med Rehabil 2008: 89: 1146-1154. – reference: Weir JP. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res 2005: 19: 231-240. – reference: Tyler TF, Nicholas SJ, Mullaney MJ, Mchugh MR. The role of hip muscle function in the treatment of patellofemoral pain syndrome. Am J Sports Med 2006: 34: 630-636. – reference: Tyler TF, Nicholas SJ, Campbell RJ, Mchugh MP. The association of hip strength and flexibility with the incidence of adductor muscle strains in professional ice hockey players. Am J Sports Med 2001: 29: 124-128. – reference: Kelln BM, Mckeon PO, Gontkof LM, Hertel J. Hand-held dynamometry: reliability of lower extremity muscle testing in healthy, physically active, young adults. J Sport Rehabil 2008: 17: 160-170. – reference: Bohannon RW. Make tests and break tests of elbow flexor muscle strength. Phys Ther 1988: 68: 193-194. – reference: Cetin C, Sekir U, Yildiz Y, Aydin T, Ors F, Kalyon TA. Chronic groin pain in an amateur soccer player. Br J Sports Med 2004: 38: 223-224. – reference: Akermark C, Johansson C. Tenotomy of the adductor Longus Tendon in the treatment of chronic groin pain in athletes. Am J Sports Med 1992: 20: 640-643. – reference: Ireland ML, Willson JD, Ballantyne BT, Davis IM. Hip strength in females with and without patellofemoral pain. J Orthop and Sports Phys Ther 2003: 33: 671-676. – reference: Lu TW, Hsu HC, Chang LY, Chen HL. Enhancing the examiner's resisting force improves the reliability of manual muscle strength measurements: comparison of a new device with hand-held dynamometry. J Rehabil Med 2007: 39: 679-684. – reference: Click FP, Bellew JW, Pitts TA, Kay RE. Reliability of stabilised commercial dynamometers for measuring hip abduction strength: a pilot study. Br J Sports Med 2003: 37: 331-334. – reference: Cichanowski HR, Schmitt JS, Johnson RJ, Niemuth PE. Hip strength in collegiate female athletes with patellofemoral pain. Med Sci Sports Exerc 2007: 39: 1227-1232. – reference: Arokoski MH, Arokoski JPA, Haara M, Kankaanpaa M, Vesterinen M, Niemitukia LH, Helminen HJ. Hip muscle strength and muscle cross sectional area in men with and without hip osteoarthritis. J Rheumatol 2002: 29: 2185-2195. – volume: 88 start-page: 37 year: 2007 end-page: 42 article-title: Influence of lever arm and stabilization on measures of hip abduction and adduction torque obtained by hand‐held dynamometry publication-title: Arch Phys Med Rehabil – volume: 11 start-page: 1 year: 1969 end-page: 21 article-title: Procedures for detecting outlying observations in samples publication-title: Technometrics – volume: 68 start-page: 454 year: 1987 end-page: 458 article-title: Strength testing with a portable dynamometer publication-title: reliability for upper and lower extremities – volume: 37 start-page: 331 year: 2003 end-page: 334 article-title: Reliability of stabilised commercial dynamometers for measuring hip abduction strength publication-title: a pilot study – volume: 22 start-page: 629 year: 2004 end-page: 636 article-title: Groin injuries in professional rugby league players publication-title: a prospective study – volume: 39 start-page: 1227 year: 2007 end-page: 1232 article-title: Hip strength in collegiate female athletes with patellofemoral pain publication-title: Med Sci Sports Exerc – volume: 29 start-page: 124 year: 2001 end-page: 128 article-title: The association of hip strength and flexibility with the incidence of adductor muscle strains in professional ice hockey players publication-title: Am J Sports Med – volume: 29 start-page: 2185 year: 2002 end-page: 2195 article-title: Hip muscle strength and muscle cross sectional area in men with and without hip osteoarthritis publication-title: J Rheumatol – volume: 19 start-page: 231 year: 2005 end-page: 240 article-title: Quantifying test–retest reliability using the intraclass correlation coefficient and the SEM publication-title: J Strength Cond Res – volume: 44 start-page: 123 year: 2007 end-page: 136 article-title: Dynamometry testing in spinal cord injury publication-title: J Rehabil Res Dev – volume: 34 start-page: 630 year: 2006 end-page: 636 article-title: The role of hip muscle function in the treatment of patellofemoral pain syndrome publication-title: Am J Sports Med – volume: 17 start-page: 160 year: 2008 end-page: 170 article-title: Hand‐held dynamometry publication-title: reliability of lower extremity muscle testing in healthy, physically active, young adults – year: 2009 article-title: Test–retest reliability of cardinal plane isokinetic hip torque and EMG publication-title: J Electromyogr Kinesiol – volume: 15 start-page: 14 year: 2005 end-page: 21 article-title: Hip muscle weakness and overuse injuries in recreational runners publication-title: Clin J Sport Med – volume: 68 start-page: 193 year: 1988 end-page: 194 article-title: Make tests and break tests of elbow flexor muscle strength publication-title: Phys Ther – volume: 38 start-page: 446 year: 2004 end-page: 451 article-title: Clinical examination of athletes with groin pain publication-title: an intraobserver and interobserver reliability study – volume: 39 start-page: 679 year: 2007 end-page: 684 article-title: Enhancing the examiner's resisting force improves the reliability of manual muscle strength measurements publication-title: comparison of a new device with hand-held dynamometry – volume: 20 start-page: 640 year: 1992 end-page: 643 article-title: Tenotomy of the adductor Longus Tendon in the treatment of chronic groin pain in athletes publication-title: Am J Sports Med – volume: 85 start-page: 598 year: 2004 end-page: 603 article-title: The intra‐ and interrater reliability of hip muscle strength assessments using a handheld versus a portable dynamometer anchoring station publication-title: Arch Phys Med Rehabil – volume: 33 start-page: 671 year: 2003 end-page: 676 article-title: Hip strength in females with and without patellofemoral pain publication-title: J Orthop and Sports Phys Ther – volume: 89 start-page: 1146 year: 2008 end-page: 1154 article-title: Intrarater test–retest reliability of hip range of motion and hip muscle strength measurements in persons with hip osteoarthritis publication-title: Arch Phys Med Rehabil – volume: 18 start-page: 349 year: 1990 end-page: 353 article-title: Subject variability of shoulder abduction strength testing publication-title: Am J Sports Med – year: 1993 – volume: 38 start-page: 223 year: 2004 end-page: 224 article-title: Chronic groin pain in an amateur soccer player publication-title: Br J Sports Med – volume: 9 start-page: 79 year: 1999 end-page: 85 article-title: Test–retest reliability of isokinetic hip adductor and flexor muscle strength publication-title: Clin J Sport Med – volume: 353 start-page: 439 year: 1999 end-page: 443 article-title: Effectiveness of active physical training as treatment for long‐standing adductor‐related groin pain in athletes publication-title: randomised trial – ident: e_1_2_7_7_1 doi: 10.1249/mss.0b013e3180601109 – ident: e_1_2_7_19_1 doi: 10.1177/036354659001800403 – volume: 22 start-page: 629 year: 2004 ident: e_1_2_7_21_1 article-title: Groin injuries in professional rugby league players publication-title: a prospective study – ident: e_1_2_7_20_1 doi: 10.1097/00042752-200501000-00004 – ident: e_1_2_7_26_1 doi: 10.1177/0363546505281808 – ident: e_1_2_7_5_1 doi: 10.1093/ptj/68.2.193 – volume: 37 start-page: 331 year: 2003 ident: e_1_2_7_9_1 article-title: Reliability of stabilised commercial dynamometers for measuring hip abduction strength publication-title: a pilot study – volume-title: Muscles testing and function year: 1993 ident: e_1_2_7_16_1 – volume: 39 start-page: 679 year: 2007 ident: e_1_2_7_18_1 article-title: Enhancing the examiner's resisting force improves the reliability of manual muscle strength measurements publication-title: comparison of a new device with hand-held dynamometry – ident: e_1_2_7_10_1 doi: 10.1097/00042752-199904000-00007 – volume: 17 start-page: 160 year: 2008 ident: e_1_2_7_15_1 article-title: Hand‐held dynamometry publication-title: reliability of lower extremity muscle testing in healthy, physically active, young 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| Snippet | Hip strength assessment plays an important role in the clinical examination of the hip and groin region. The primary aim of this study was to examine the... |
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| SubjectTerms | Adult Evaluation Female Groin hip Hip - physiology Hip joint Hips Humans Isometrics Male Measurement Medical equipment Medical tests Muscle Strength - physiology Muscle Strength Dynamometer rehabilitation Reproducibility of Results Sport science Strength strength ratio Young Adult |
| Title | Clinical assessment of hip strength using a hand-held dynamometer is reliable |
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