Reliability of Muscle Strength and Muscle Power Assessments Using Isokinetic Dynamometry in Neuromuscular Diseases: A Systematic Review.
Danny R van der Woude, Thijs Ruyten, Bart Bartels
PMID 35899532WHAT IT FOUND
Isokinetic dynamometry is reliable for measuring strength in postpoliomyelitis syndrome, especially isometric tests.
Evidence is weak for other neuromuscular diseases. Use peak torque or maximum voluntary contraction; avoid angle at peak torque.
Key findings
01High-quality evidence supports the reliability of isometric strength measurements using highest maximum voluntary contraction in patients with postpoliomyelitis syndrome.
02Evidence for reliability in other neuromuscular diseases, such as hereditary motor and sensory neuropathy and myotonic dystrophy, is low to very low due to small sample sizes and methodological flaws.
03Angle at peak torque is an inappropriate outcome measure because it showed insufficient reliability, whereas highest peak torque and highest MVC were reliable.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Most included studies had small sample sizes, reducing the precision of reliability estimates. Many studies excluded patients who could not reach the preset velocity, meaning results may not apply to the weakest patients. Measurement error could not be fully assessed because studies did not define what change in strength is clinically meaningful. The review did not assess the feasibility of using these devices in routine clinical practice.
The easy way to misread this
Do not assume isokinetic dynamometry is equally reliable for all neuromuscular diseases. The strong evidence applies specifically to postpoliomyelitis syndrome; for conditions like motor neuron disease or muscular dystrophy, the reliability is uncertain and based on very few participants.