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Official Journal of the , , , ,
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Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
Online ISSN 1973-9095
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.