Hand-held dynamometry reliability in persons with neuropathic weakness

Objective: To determine test-retest reliability of hand-held dynamometry (HHD) in measuring strength of persons with neuropathic weakness. Design: Intratester and intertester reliability of HHD-measured strength over a 7- to 10-day period. In addition, HHD knee strength was compared with criterion standard of fixed dynamometry (FD). Setting: Human performance laboratory of a university. Participants: Convenience sample of ambulatory outpatients with Hereditary Motor and Sensory Neuropathy, Type I (HMSN) (n = 10) and able-bodied controls (CTL) (n = 11). Main Outcome Measure: Maximal isometric torque. Results: Intratester intraclass correlation coefficients (ICCs) were high, generally ranging from .82 to .96 for HHD- and FD-measured strength for both HMSN and CTL groups. There were no significant differences between sesions for HHD-measured strength, while ED-measured strength was only significantly different for knee extension (p < .01). Intertester reliability was generally good for both HHD- and FD-measured strength, with ICCs ranging from .72 to .97 for HMSN and CTL groups. Exceptions were knee extensors and ankle dorsiflexors for the CTL group. Knee extensor strength was significantly lower measured by HHD compared with FD (p < .01), but knee flexor strength was similar for the two methods. Conclusion: HHD appears to be a reliable method to measure maximal isometric strength in persons with neurogenic weakness, and may be useful to quickly and objectively evaluate strength in the clinical setting. (C) 1997 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.