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Validity and reliability of newly developed hip muscle strength tests
ESMAC 2012 abstract / Gait & Posture 38 (2013) S1–S116
healthy subjects. The work is made with regard to have a reference for analyzing subjects with lower limb prostheses and balancing arm movements. Patients/materials and methods: Ten healthy subjects (22–43 years, 7 males, 3 females) with no histories for neurologic, orthopedic and vestibular diseases participated in the study. 3D-kinematic data is collected with a 12-camera Vicon system while walking on level ground as well as ascending and descending (2.5◦ /5.0◦ /7.5◦ inclined surfaces) at their normal self-selected speed. The Vicon’s lower body “Plugin-Gait model” is combined with an upper extremity model [1] for fullbody gait analysis. A “gait-line” is defined as projection of the pelvis center (mid point of the three markers placed on the pelvis) to the floor. Step width is determined as orthogonal distance of the “foot midpoint” (mid point between ankle joint center and toe marker) to the gait-line at foot strike. Stride width is defined as sum of corresponding left and right step width. A combined center of mass for both arms together (ArmsCoM) is calculated and its position relative to the upright is determined as a projection angle in the frontal plane (ad/abduction). Results: Stride width and standard deviation is enhanced with increased inclination angle, e.g. between level walking and uphill walking on 7.5◦ inclined surface there is a mean difference about (10 ± 20)%. The figure shows ad-/abduction movement of the ArmsCoM normalized to 100% of a gaitcycle for different strides of the same subject. No differences are found in ArmsCoM pattern between level and up-/downhill walking on inclined surfaces with different inclination angles. Furthermore no differences are found in the amplitudes of the maximum in stance phase and the minimum in swing phase and also no differences are found in its position in the gaitcycle. Discussion and conclusions: Larger stride width compensate for higher needs to achieve mediolateral balance during slope walking. Increased standard deviation can be interpreted to show less stability but for healthy subjects the arms are not involved in compensation. Reference [1] Rettig O, et al. Gait Posture 2009;30:469–76.
http://dx.doi.org/10.1016/j.gaitpost.2013.07.188 P10 Validity and reliability of newly developed hip muscle strength tests Christophe Meyer 1,2 , Kristoff Corten 2 , Mariska Wesseling 3 , Jean-Pierre Simon 2 , Ilse Jonkers 3 , Kaat Desloovere 1 1
KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium 2 UZ Leuven, University Hospital Pellenberg, Orthopedic Department, Pellenberg, Belgium 3 KU Leuven, Department of Movement Sciences, Leuven, Belgium Introduction: Isokinetic dynamometer is considered the golden standard for muscle strength testing. The studies dedicated to the hip joint revealed that participants’ positioning is of paramount importance: standing vs lying position [1,2]. Different testing positions and methods, in a variety of population, highlighted variable reliability results for hip torque measurements [3,4]. This study aimed to develop a standardized test set-up for the assessment of hip muscle strength with an optimal patient stability and to define the psychometric characteristics of these setups.
S91
Table 1 Intraclass correlation values for the different notion tests with the reported standard errors of measurement (SEM) expressed in Newton meters.
Hip abduction Hip adduction Hip flexion Hip extension
Peak torque
Peak torque 60◦ /s
Peak torque 120◦ /s
0.93 (10.22) – 0.98 (2.47) 0.72 (23.06)
0.91 (12.11) 0.69 (16) 0.97 (8) 0.88 (12.52)
0.90 (12.41) 0.74 (15.65) 0.93 (9.96) 0.72 (23.06)
Fig. 1. (A) Hip abduction/adduction test. (B) Hip flexion/extension test.
Patients/materials and methods: A total of 5 men and 2 women, with a median (and interquartile range) age of 30 (26.5–33.5) years, height of 180 (176–183) cm, weight of 77.2 (65.6–85.6) kg and body mass index of 23.81 (21–26.9) kg/m2 , volunteered to participate in this study. Isometric and isokinetic peak torques were assessed using the Biodex dynamometer during two test sessions, separated by 1 week interval. Hip abduction/adduction and hip flexion/extension were performed at a concentric/concentric mode after a 10 min warm-up cycling exercise. Participants first performed 3 submaximal repetitions, followed by 3 isokinetic contractions at 60◦ /s and 120◦ /s and finally 3 sustained isometric (6s) contractions. A sufficient rest period (up to 5 min) was always set between the different testing position and condition. The new testing positions, where focus was given to stabilization using straps and braces, are presented in Fig. 1. Test–retest reliability of peak torque was assessed via the intra-class correlation (ICC) coefficient (2.1) [5]. The standard error of measurement (SEM) was calculated as well the minimum detectable change at the 95% confidence interval (MDC95 ) [6]. Results: Table 1. Discussion and conclusions: This study revealed that our new hip muscle strength setups allow more reliable and repeatable measures of maximal hip contractions for hip abduction and hip flexion that could have been measured until now (≥0.90). The least reliable measures were found for hip extension and hip adduction, which could be explained by a less efficient stabilization technique. References [1] [2] [3] [4] [5] [6]
Barbic S, et al. Archives of Physical Medicine and Rehabilitation 2008. Claiborne TL, et al. Journal of Electromyography and Kinesiology 2009. Arokoski MH, et al. Journal of Rheumatology 2002. Widler KS, et al. The Journal of Bone and Joint Surgery 2009. Shrout PE, Fleiss JL. Psychological Bulletin 1979. Stratford PW. Physiotherapy Canada 2004.
http://dx.doi.org/10.1016/j.gaitpost.2013.07.189
healthy subjects. The work is made with regard to have a reference for analyzing subjects with lower limb prostheses and balancing arm movements. Patients/materials and methods: Ten healthy subjects (22–43 years, 7 males, 3 females) with no histories for neurologic, orthopedic and vestibular diseases participated in the study. 3D-kinematic data is collected with a 12-camera Vicon system while walking on level ground as well as ascending and descending (2.5◦ /5.0◦ /7.5◦ inclined surfaces) at their normal self-selected speed. The Vicon’s lower body “Plugin-Gait model” is combined with an upper extremity model [1] for fullbody gait analysis. A “gait-line” is defined as projection of the pelvis center (mid point of the three markers placed on the pelvis) to the floor. Step width is determined as orthogonal distance of the “foot midpoint” (mid point between ankle joint center and toe marker) to the gait-line at foot strike. Stride width is defined as sum of corresponding left and right step width. A combined center of mass for both arms together (ArmsCoM) is calculated and its position relative to the upright is determined as a projection angle in the frontal plane (ad/abduction). Results: Stride width and standard deviation is enhanced with increased inclination angle, e.g. between level walking and uphill walking on 7.5◦ inclined surface there is a mean difference about (10 ± 20)%. The figure shows ad-/abduction movement of the ArmsCoM normalized to 100% of a gaitcycle for different strides of the same subject. No differences are found in ArmsCoM pattern between level and up-/downhill walking on inclined surfaces with different inclination angles. Furthermore no differences are found in the amplitudes of the maximum in stance phase and the minimum in swing phase and also no differences are found in its position in the gaitcycle. Discussion and conclusions: Larger stride width compensate for higher needs to achieve mediolateral balance during slope walking. Increased standard deviation can be interpreted to show less stability but for healthy subjects the arms are not involved in compensation. Reference [1] Rettig O, et al. Gait Posture 2009;30:469–76.
http://dx.doi.org/10.1016/j.gaitpost.2013.07.188 P10 Validity and reliability of newly developed hip muscle strength tests Christophe Meyer 1,2 , Kristoff Corten 2 , Mariska Wesseling 3 , Jean-Pierre Simon 2 , Ilse Jonkers 3 , Kaat Desloovere 1 1
KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium 2 UZ Leuven, University Hospital Pellenberg, Orthopedic Department, Pellenberg, Belgium 3 KU Leuven, Department of Movement Sciences, Leuven, Belgium Introduction: Isokinetic dynamometer is considered the golden standard for muscle strength testing. The studies dedicated to the hip joint revealed that participants’ positioning is of paramount importance: standing vs lying position [1,2]. Different testing positions and methods, in a variety of population, highlighted variable reliability results for hip torque measurements [3,4]. This study aimed to develop a standardized test set-up for the assessment of hip muscle strength with an optimal patient stability and to define the psychometric characteristics of these setups.
S91
Table 1 Intraclass correlation values for the different notion tests with the reported standard errors of measurement (SEM) expressed in Newton meters.
Hip abduction Hip adduction Hip flexion Hip extension
Peak torque
Peak torque 60◦ /s
Peak torque 120◦ /s
0.93 (10.22) – 0.98 (2.47) 0.72 (23.06)
0.91 (12.11) 0.69 (16) 0.97 (8) 0.88 (12.52)
0.90 (12.41) 0.74 (15.65) 0.93 (9.96) 0.72 (23.06)
Fig. 1. (A) Hip abduction/adduction test. (B) Hip flexion/extension test.
Patients/materials and methods: A total of 5 men and 2 women, with a median (and interquartile range) age of 30 (26.5–33.5) years, height of 180 (176–183) cm, weight of 77.2 (65.6–85.6) kg and body mass index of 23.81 (21–26.9) kg/m2 , volunteered to participate in this study. Isometric and isokinetic peak torques were assessed using the Biodex dynamometer during two test sessions, separated by 1 week interval. Hip abduction/adduction and hip flexion/extension were performed at a concentric/concentric mode after a 10 min warm-up cycling exercise. Participants first performed 3 submaximal repetitions, followed by 3 isokinetic contractions at 60◦ /s and 120◦ /s and finally 3 sustained isometric (6s) contractions. A sufficient rest period (up to 5 min) was always set between the different testing position and condition. The new testing positions, where focus was given to stabilization using straps and braces, are presented in Fig. 1. Test–retest reliability of peak torque was assessed via the intra-class correlation (ICC) coefficient (2.1) [5]. The standard error of measurement (SEM) was calculated as well the minimum detectable change at the 95% confidence interval (MDC95 ) [6]. Results: Table 1. Discussion and conclusions: This study revealed that our new hip muscle strength setups allow more reliable and repeatable measures of maximal hip contractions for hip abduction and hip flexion that could have been measured until now (≥0.90). The least reliable measures were found for hip extension and hip adduction, which could be explained by a less efficient stabilization technique. References [1] [2] [3] [4] [5] [6]
Barbic S, et al. Archives of Physical Medicine and Rehabilitation 2008. Claiborne TL, et al. Journal of Electromyography and Kinesiology 2009. Arokoski MH, et al. Journal of Rheumatology 2002. Widler KS, et al. The Journal of Bone and Joint Surgery 2009. Shrout PE, Fleiss JL. Psychological Bulletin 1979. Stratford PW. Physiotherapy Canada 2004.
http://dx.doi.org/10.1016/j.gaitpost.2013.07.189