Abstract
The purpose of this study is to establish the absolute reliability between hand-held dynamometers (HHDs) and concurrent validity between HHDs and isokinetic dynamometers (IDs) in shoulder rotator strength assessment. The Medline, CINAHL, and Central databases were searched for relevant studies up to July 2020. Absolute reliability was determined by test–retest studies presenting standard error of measurement (SEM%) and/or minimal detectable change (MDC%) expressed as percentage of the mean. Studies considering intra-class correlation coefficient (ICC) between IDs and HHDs were considered for concurrent validity. The risk of bias and the methodological quality were evaluated according to COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Thirteen studies were included in the meta-analysis. Shoulder internal rotator strength assessment MDC% was 0.78%, 95% confidence interval (CI) −5.21 to 3.66, while shoulder external rotators MDC% was 3.29%, CI −2.69 to 9.27. ICC between devices was 0.94, CI (0.91 to 0.96) for shoulder internal rotators and 0.92, IC (0.88 to 0.97) for shoulder external rotators. Very high correlation was found for shoulder rotator torque assessment between HHDs and IDs. The COSMIN checklist classified the selected studies as adequate and inadequate.
Highlights
Seventy-four studies were considered for full-text review after removal of excluded studies and duplicates
Two studies were not considered due to values not being shown in kgs or pounds for hand-held dynamometers (HHDs) assessments
Descriptions of characteristics and outcomes of studies considering absolute reliability of HHD are presented in Tables 1 and 2
Summary
Muscle strength assessment is relevant in patients with shoulder disorders [1,2]. Isokinetic and hand-held dynamometers (HHDs) are useful tools for clinicians to objectively assess muscle strength, quantify the degree of impairment, and evaluate treatment efficacy when performed before and after an intervention [3,4]. Isokinetic dynamometers (IDs) are considered the reference standard in muscle testing. Considered to be the gold standard, isokinetic testing is limited in clinical settings because of the high cost and the laboratory setting required. HHDs are considered low cost, with convenient size and easy use of instruments, but their psychometric properties in shoulder rotator strength assessment are not clearly understood. Relevant psychometric properties include absolute reliability and concurrent validity analysis. Absolute reliability determines variations in repeated measurements performed multiple times under similar conditions [6,7], ensuring that changes between measurements are due to differences in performance instead of inconsistency in measuring the capacity of the applied device [8]
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