Background. The quadriceps is a strong muscle group that is likely to overpower clinicians during the assessment of muscle strength using isometric contraction methods. Testing the quadriceps using a concentric, or dynamic, contraction method may assist clinicians in detecting the presence of unilateral quadriceps weakness. To date, there are no studies that examine the reliability and diagnostic accuracy of dynamic manual muscle testing (MMT). Objectives. The purpose of this study was to compare the reliability and diagnostic accuracy of isometric and dynamic manual muscle testing in assessing asymmetrical quadriceps strength in persons with and without suspected unilateral lower extremity dysfunction. Methods. Twenty-six subjects with an age range of 18 to 56 years (mean of 32.6 years) were tested using the following test procedures: isometric MMT, dynamic MMT, isometric dynamometry using the Biodex system and isokinetic dynamometry using the Biodex system. Manual muscle tests were performed by two licensed physical therapists. The Biodex isokinetic dynamometer was used as a reference standard for the determination of asymmetrical quadriceps strength. A comparison of dynamic MMT to isokinetic Biodex dynamometry, and isometric MMT to isometric Biodex dynamometry were performed at 10, 15 and 20 percent between-side differences in quadriceps strength. Results. The percent agreement between isometric MMT and isometric Biodex testing was 51.9 at 10%, 55.8 at 15% and 61.5 at 20% between-side differences in strength. The percent agreement between dynamic MMT and isokinetic Biodex testing was 55.8 at 10%, 57.7 at 15% and 65.4 at 20% between-side difference in quadriceps strength. Conclusion. The low values of diagnostic adequacy of both isometric and dynamic MMT found in this study highlight the inadequacy of manual muscle testing as a diagnostic test for quadriceps strength impairment. However, despite this inadequacy, dynamic MMT was shown to have comparable diagnostic accuracy values to isometric MMT. Further studies are needed to establish the reliability and diagnostic accuracy of dynamic MMT.Conclusion. The low values of diagnostic adequacy of both isometric and dynamic MMT found in this study highlight the inadequacy of manual muscle testing as a diagnostic test for quadriceps strength impairment.
|Title||:||Comparison of the Diagnostic Accuracy of Dynamic Versus Isometric Manual Muscle Testing in the Assessment of Quadriceps Muscle Strength in Persons with and Without Suspected Unilateral Lower Extremity Dysfunction|
|Publisher||:||ProQuest - 2007|