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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
A Journal on Physical Medicine and Rehabilitation after Pathological Events
Official Journal of the , , , ,
In association with
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
European Journal of Physical and Rehabilitation Medicine 2013 December;49(6):803-13
Feasibility and test-retest reliability of measuring lower‑limb strength in young children with cerebral palsy
Van Vulpen L. F. 1, De Groot S. 1, 2, Becher J. G. 3, 4, De Wolf G. S. 5, Dallmeijer A. J. 3, 4 ✉
1 Amsterdam Rehabilitation Research Center / Reade Amsterdam, The Netherlands;
2 University of Groningen, University Medical Center Groningen Center for Human Movement Sciences Groningen, The Netherlands;
3 Department of Rehabilitation Medicine VU University Medical Center, Amsterdam, The Netherlands;
4 Research Institute MOVE, VU University Medical Center, Amsterdam, The Netherlands;
5 Departement of Clinical Epidemiology Biostatistics and Bioinformatics, Academic Medical Center University of Amsterdam, Amsterdam, The Netherlands
Background: Quantifying leg muscle strength in young children with cerebral palsy (CP) is essential for identifying muscle groups for treatment and for monitoring progress.
Aim: To study the feasibility, intratester reliability and the optimal test design (number of test occasions and repetitions) of measuring lower-limb strength with handheld dynamometry (HHD) and dynamic ankle plantar flexor strength with the standing heel-rise (SH) test in 3-10 year aged children with CP.
Design: Test-retest design.
Setting: Rehabilitation centre, special needs school for children with disabilities, and university medical centre.
Methods: Knee extensor, hip abductor and calf muscle strength was assessed in 20 ambulatory children with spastic CP (3-5 years [N.=10] and 6-10 years [N.=10]) on two test occasions. Intraclass correlation coefficients (ICC) and Smallest Detectable Differences (SDD) were calculated to determine the optimal test design for detecting changes in strength.
Results: All isometric strength tests had acceptable SDDs (9-30%), when taking the mean values of 2-3 test occasions (separate days) and 2-3 repetitions. The one-leg SH test had large SDDs (40-128% for younger group, 23-48% for older group).
Conclusion: Isometric strength (improvements) can only be measured reliably with HHD in young children with CP when the average values over at least 2 test occasions are taken. Reliability of the SH test is not sufficient for measuring individual changes in dynamic muscle strength in the younger children.
Clinical Rehabilitation Impact: Results of this study can be used to determine the optimal number of test occasions and repetitions for reliable HHD measurements depending on expected changes, muscle group and age in 3-10 year old children with CP.