Hand-Held Dynamometer is a Reliable Tool to Measure Trunk Muscle Strength in Chronic Stroke

J Clin Diagn Res. 2017 Sep;11(9):YC09-YC12. doi: 10.7860/JCDR/2017/28105.10672. Epub 2017 Sep 1.

Abstract

Introduction: Patients with chronic stroke show atypical coordination of trunk movement and they find difficulty during bed mobility and transfer skills due to weakness of trunk muscles. Routine bedside clinical examination fails to quantify the trunk muscle strength in patients with stroke. Handheld dynamometer is widely administered to quantify the strength of extremities, but its reliability on testing the trunk muscles strength is limited.

Aim: This study aimed at examining the reliability of hand-held dynamometer to quantify the strength of trunk muscle groups in chronic stroke.

Materials and methods: This reliability study was conducted in outpatient clinical settings. Patients with chronic stroke aged between 30 and 80 years and an ambulatory capacity of 10-meter distance volunteered in the study. The strength of trunk flexors, extensors, rotators towards most and least affected sides and bilateral lateral flexors was examined by break test using hand-held dynamometer and the isometric strength was reported in pounds (lb.). These tests were carried out by two physical therapists independently at two time points and the assessment procedure was standardized. Pearson's correlation test was conducted to observe the reliability of dynamometer strength testing i.e., internal consistency of the measure and intra-class correlation coefficient (r).

Results: Of the 85 study participants, 51 of them had most trunk involvement on the left side and 34 had it on the right side. This study showed an excellent intra-rater (0.88-0.98) and inter-rater (0.84-0.96) reliability of trunk muscle strength testing using hand-held dynamometer.

Conclusion: Hand-held dynamometer showed excellent intra and inter tester reliability to quantify the trunk muscle strength in patients with chronic stroke. So this tool can easily be administered in clinical and rehabilitation settings for diagnostic and prognostic purposes.

Keywords: Mobility functioning; Neuro-physiological procedures; Trunk weakness.