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      Assessment of muscular strength with the modified sphygmomanometer test: what is the best method and source of outcome values?

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          Abstract

          Background

          Tests that are usually employed for the clinical assessment of muscular strength have notable disadvantages. The Modified Sphygmomanometer Test (MST) is a promising method because it is low-cost and provides objective measures.

          Objectives

          To investigate the most adequate method and sources of outcome values for the assessment of strength with the MST.

          Method

          Methodological study with 40 healthy adults (22.98±2.26 years), who did not practice physical activity regularly. The strength of the flexors and extensors of the elbow and knee, the handgrip of the dominant side and anterior trunk flexors were randomly assessed with portable dynamometers and the MST (bag and cuff adaptations, and sphygmomanometer without adaptation) by a single examiner. An independent examiner read and recorded the values. The sources of the investigated outcome values were the first trial and the means of two and three trials. One-way ANOVAs and Pearson Correlation Coefficients were used for the analyses (α=0.05).

          Results

          For the MST methods applied to assess all muscular groups, similar values were found for all sources of outcome values (0.01< F<0.26; 0.77< p<1.00) with significant and positive correlations between the measures obtained with the dynamometers (0.51< r<0.94; p<0.003).

          Conclusions

          All MST methods showed adequate results for the assessment of strength in healthy individuals, and after familiarization, only one trial was sufficient to provide reliable measures. The sphygmomanometer without adaptation is not time consuming, compared to the other adaptations, and showed the capability of measuring higher values of strength. The bag method was easily trained to be used and stabilized.

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          Most cited references90

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          Reference values for extremity muscle strength obtained by hand-held dynamometry from adults aged 20 to 79 years.

          R Bohannon (1997)
          Only a few studies have provided reference values for muscle strength obtained by hand-held dynamometry. Such values are essential for establishing the degree to which an individual's strength is impaired. This descriptive study was conducted to provide reference values for the strength of 10 extremity muscle actions. SUBJECTS AND INSTRUMENTATION: A convenience sample of 106 men and 125 women volunteers was tested twice with an Ametek digital hand-held dynamometer. The measurements were found to be reliable. Predictive equations are provided for the measurements. Reference values generated are expressed in Newtons and as a percentage of body weight and are organized by gender, decade of age, and side. The values can be employed in a clinical setting to document whether an individual is impaired relative to healthy subjects of the same gender and age.
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            Measurement of grip strength: validity and reliability of the sphygmomanometer and jamar grip dynamometer.

            Quantitative measurement of grip strength is an important variable when plotting the progress of a hand-injured patient. When utilizing traditional commercially available apparatuses, obtaining meaningful grip strength measurement in these subjects is frequently difficult due to severe deformity, high tissue sensitivity, and low levels of force generated. The purpose of this study was to measure hand grip strength using two instruments having different physical characteristics and units of measurement to determine the reliability of repeated measures with each instrument. Additionally, validity of the sphygmomanometer for strength measurement was established through comparison with the values obtained from measurements using the research-validated Jamar dynamometer. Twenty-nine right hand dominant female college-age subjects volunteered to perform hand grip strength testing. Measurements were taken with a sphygmomanometer and a Jamar dynamometer while utilizing standardized measurement procedures. A Spearman Rho correlation coefficient test utilized in measuring within-instrument reliability showed a high correlation for each instrument at .85 for the sphygmomanometer and .82 for the Jamar dynamometer. Construct validity testing performed to determine validity of the measurements by the sphygmomanometer compared with the Jamar dynamometer produced a .75 correlation. A formula for conversion of the sphygmomanometer scores into Jamar units was developed to enhance reporting of sphygmomanometer scores utilizing the Jamar standard. The study showed that the sphygmomanometer and Jamar dynamometer exhibit good within-instrument reliability. Validity of the sphygmomanometer as a grip measurement device is acceptable and reportable using the conversion formula developed. Therefore, it can be utilized with confidence as essentially equal to the Jamar unit for grip strength measurement. J Orthop Sports Phys Ther 1992;16(5):215-219.
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              Hand-held dynamometry: reliability of lower extremity muscle testing in healthy, physically active,young adults.

              Hand-held dynamometry (HHD) has been shown to be a reliable, objective way to obtain strength measurements in elderly and physically impaired subjects. To estimate the intratester, intertester, and intersession reliability of HHD testing of lower extremity movements in young, healthy subjects. Repeated measures. Sports medicine laboratory. Nine males and eleven females (Mean age = 26 years). Strength measures of 11 right lower extremity movements were taken by 3 different testers on 2 separate days using a HHD. Intratester ICC range was .77 to .97 with SEM range of .01 to .44 kg. Mean intertester ICC range was .65 to .87 with SEM range of .11 to 1.05 kg. Mean intersession ICC range was .62 to .92 with SEM range of .01 to .83 kg. HHD has the potential to be a reliable tool for strength measurements in healthy, strong subjects; however, there are noteworthy limitations with movements where subjects can overpower the testers.
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                Author and article information

                Journal
                Braz J Phys Ther
                Braz J Phys Ther
                Brazilian Journal of Physical Therapy
                Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
                1413-3555
                1809-9246
                Mar-Apr 2014
                : 18
                : 2
                : 191-200
                Affiliations
                [1 ] Rehabilitation Sciences Graduate Program, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
                [2 ] Physical Therapy Department, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil
                Author notes
                Correspondence: Christina Danielli Coelho de Morais Faria, Universidade Federal de Minas Gerais, Departamento de Fisioterapia, Av. Antônio Carlos, 6627, Campus Pampulha, CEP 31270-901, Belo Horizonte, MG, Brasil. e-mail: cdcmf@ 123456ufmg.br ; chrismoraisf@ 123456yahoo.com
                Article
                10.1590/S1413-35552012005000149
                4183243
                24839045
                2396bcb6-d650-4a89-9cc4-ac8cd944732d

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 01 July 2013
                : 20 September 2013
                : 23 October 2013
                Categories
                Original Articles

                rehabilitation,muscular strength,assessment,upper extremity,lower extremity,trunk

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