Characteristics of patients with hemiparetic stroke who yield highly reliable muscle strength measurements.
Ken Tomida, Genichi Tanino, Shinya Sasaki and 3 others
PMID 28533590WHAT IT FOUND
Stroke patients with a Functional Independence Measure cognitive score of 19 or higher produced consistent muscle strength measurements.
Below this threshold, results were too variable to trust. Clinicians should check this score before relying on dynamometer data for treatment planning.
Key findings
01Patients with a Functional Independence Measure cognitive score of 19 or higher yielded highly reliable isokinetic knee extensor strength measurements.
02A Functional Independence Measure cognitive score of 19 was the cutoff value that best distinguished patients who could produce consistent strength measurements from those who could not.
03Cognitive ability was a stronger predictor of measurement reliability than the severity of motor paralysis or physical function.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study only included patients who could sit independently and had measurable strength, excluding those with severe impairments. The classification of Acceptable versus Unacceptable relied on assumed measurement error and strength gain rates from previous literature rather than direct calculation in this specific cohort. The sample size was small, with only twelve patients in the Unacceptable group, which may limit the generalizability of the cutoff score. The study did not account for potential fluctuations in patient effort or motivation between the two testing days beyond the cognitive score.
Declared interests
No specific conflicts of interest or funding sources were declared in the provided text.
The easy way to misread this
Do not assume that a cognitive score below 19 means the patient cannot improve strength. It only means their measured strength values are inconsistent and unreliable for tracking progress or setting precise targets. The patient may still benefit from therapy, but the dynamometer numbers cannot be trusted.