INLINE DYNAMOMETRY PROVIDES RELIABLE MEASUREMENTS OF QUADRICEPS STRENGTH IN HEALTHY AND ACL-RECONSTRUCTED INDIVIDUALS AND IS A VALID SUBSTITUTE FOR ISOMETRIC ELECTROMECHANICAL DYNAMOMETRY FOLLOWING ACL RECONSTRUCTION

Abstract

BackgroundQuadriceps strength testing is recommended to guide rehabilitation and mitigate the risk of second injury following anterior cruciate ligament (ACL) reconstruction. Hand-held dynamometry is a practical alternative to electromechanical dynamometry but demonstrates insufficient reliability and criterion validity in healthy and ACL-reconstructed participants respectively. The purpose of this study is to investigate the reliability and concurrent validity of inline dynamometry for measuring quadriceps strength. The hypotheses are that intra-class correlation coefficient (ICC) values will be >0.90 for reliability and concurrent validity. MethodsThis was a cross sectional study using a within-participant, repeated measures design. Isometric quadriceps testing was performed at 60° knee flexion in 50 healthy and 52 ACL-reconstructed participants. Interrater reliability, intrarater reliability, and concurrent validity of inline dynamometry was investigated through calculation of intra-class correlation coefficients (ICCs), Bland-Altman analysis, linear regression, standard error of measurement (SEM) and minimal detectable change (MDC). ResultsThe lower bounds of the 95% confidence intervals were >0.90 for all reliability and validity ICCs in healthy and ACL-reconstructed participants, except for intrarater reliability in healthy participants using absolute scores (ICC = 0.936 [95% CI 0.890-0.963]). In ACL-reconstructed participants, Bland-Altman bias was 0.01 Nm/kg for absolute and average scores, limits of agreement were -11.74% to 12.59% for absolute scores, the SEM was 0.13Nm/kg (95% CI 0.10 - 0.17) and the MDC was 0.36Nm/kg (95% CI 0.28 – 0.47). ConclusionInline dynamometry is a reliable and economical alternative to electromechanical dynamometry for the assessment of quadriceps strength following ACL-reconstruction.Clinical trial registration number: ClinicalTrials.gov (NCT05109871)