Reliability, Validity and Minimal Detectable Change of a Power Leg Press Test in Individuals with Cerebral Palsy.
Mattie Pontiff, Li Li, Noelle G Moreau
PMID 36722739WHAT IT FOUND
A modified leg press test reliably measures leg power in children and adults with cerebral palsy.
To detect true change, average peak power must improve by more than 10.7% in adults or 19% in children. This test takes 15 minutes and costs about $6,500.
Key findings
01The test showed excellent reliability within a session and between sessions, with Intraclass Correlation Coefficients (ICCs) ranging from 0.944 to 0.988.
02Correlations with a gold-standard isokinetic dynamometer were good to excellent (r=0.746–0.883), confirming the test accurately measures leg power.
03Average peak power was the most precise measure, requiring a change of >10.7% in adults and >19% in children to exceed measurement error.
STILL TO COME
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What it does not show
The study included only 26 participants, limiting the generalizability of the Minimal Detectable Change values. The test requires specialized equipment (linear position transducer, computer with custom code) and a modified leg press, which may not be available in all clinics. Participants had to grip a handlebar tightly, which may be difficult for individuals with significant upper extremity involvement (though wrist straps were used as a workaround). The test has not yet been evaluated in a real-world clinical setting for feasibility or acceptability by therapists.
Declared interests
The authors declare no conflict of interest.
The easy way to misread this
Do not assume any increase in power is clinically meaningful. Small changes, particularly in children, may fall within the measurement error. Use the specific Minimal Detectable Change thresholds (10.7% for adults, 19% for children) for average peak power to confirm true improvement.