Physical Therapy Korea (한국전문물리치료학회지)

Korean Research Society of Physical Therapy (한국전문물리치료학회)
권호 표지

Agreement of Manual Muscle Testing and Test-Retest Reliability of Hand Held Dynamometer for the Posterior Gluteus Medius Muscle for Patients With Low Back Pain

요통 환자를 대상으로 후중둔근 도수근력검사의 일치도 및 휴대용 근력계 측정 방법의 신뢰도 검사

  • Park, Kyue-Nam (Dept. of Rehabilitation Therapy, The Graduate School, Yonsei University) ;
  • Kim, Hyun-Sook (Dept. of Physical therapy, Yeojoo Institute of Technology) ;
  • Choi, Houng-Sik (Dept. of Physical therapy, Hanseo University) ;
  • Lee, Won-Hwee (Dept. of Rehabilitation Therapy, The Graduate School, Yonsei University) ;
  • Ha, Sung-Min (Dept. of Rehabilitation Therapy, The Graduate School, Yonsei University) ;
  • Kim, Su-Jung (Dept. of Rehabilitation Therapy, The Graduate School, Yonsei University)
  • 박규남 (연세대학교 대학원 재활학과) ;
  • 김현숙 (여주대학교 물리치료과) ;
  • 최흥식 (한서대학교 물리치료과) ;
  • 이원휘 (연세대학교 대학원 재활학과) ;
  • 하성민 (연세대학교 대학원 재활학과) ;
  • 김수정 (연세대학교 대학원 재활학과)
  • Received : 2011.05.24
  • Accepted : 2011.08.08
  • Published : 2011.09.17
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this study was to assess the agreement of manual muscle testing (MMT) and test-retest reliability of a hand held dynamometer for the posterior gluteus medius muscle, with and without lumbar stabilization, using a pressure biofeedback unit for patients with low back pain. The pressure biofeedback unit was used to minimize the substitute motion of the lumbopelvic region during hip abduction in patients lying on their side. Fifteen patients with low back pain participated in this study. A tester determined the MMT grades of the posterior gluteus medius with and without the pressure biofeedback unit. Active hip abduction range of motion with an inclinometer and the strength of their posterior gluteus medius using a hand held dynamometer were measured with and without the pressure biofeedback unit in the MMT position. The agreement of the grade of muscle strength in the MMT, and intra-rater reliability of both the active hip abduction range of motion and the strength of posterior gluteus medius were analyzed using the weighted kappa and intraclass correlation coefficient (ICC), respectively. The agreement of MMT with the pressure biofeedback unit (weighted kappa=.92) was higher than the MMT (weighted kappa=.34)(p<.05). The inclinometer with pressure biofeedback unit measurement of the active hip abduction range of motion had an excellent intra-rater reliability (ICC=.90). Also, the hand held dynamometer with pressure biofeedback unit measure of strength of the posterior gluteus medius had a good intra-rater reliability (ICC=.85). Therefore, the test for muscle strength with pressure biofeedback unit will be a reliable method for the determination of the MMT grades or amount of posterior gluteus medius muscle strength and the measurement of the range of motion for hip abduction in patients with low back pain.

Keywords

References

  1. Arab AM, Nourbakhsh MR. The relationship between hip abductor muscle strength and iliotibial band tightness in individuals with low back pain. Chiropr Osteopat. 2010;18:1. https://doi.org/10.1186/1746-1340-18-1
  2. Blackman NJ, Koval JJ. Interval estimation for Cohen's kappa as a measure of agreement Stat Med. 2000;19:723-741. https://doi.org/10.1002/(SICI)1097-0258(20000315)19:5<723::AID-SIM379>3.0.CO;2-A
  3. Chaitow L, Muscle Energy Techniques. London, Churchill Livingstone, 1996.
  4. Click Fenter P, Bellew JW, Pitts TA, et al. Reliability of stabilised commercial dynamometers for measuring hip abduction strength: A pilot study. Br J Sports Med. 2003;37(4):331-334. https://doi.org/10.1136/bjsm.37.4.331
  5. Cuthbert SC, Goodheart GJ Jr. On the reliability and validity of manual muscle testing: A literature review. Chiropr Osteopat. 2007;15:4. https://doi.org/10.1186/1746-1340-15-4
  6. Cynn HS, Oh JS, Kwon OY, et al. Effects of lumbar stabilization using a pressure biofeedback unit on muscle activity and lateral pelvic tilt during hip abduction in sidelying. Arch Pbys Med Rehabil. 2006;87(11):1454-1458. https://doi.org/10.1016/j.apmr.2006.08.327
  7. Devita P, Hunter PB, Skelly WA. Effects of a functional knee brace on the biomechanics of running. Med Sci Sports Exerc. 1992;24:797-806.
  8. Dunn JC, Maura D. Interater reliability of knee muscle forces obtained by hand-held dynamometer from elderly subjects with degenerative back pain. J Geriatr Phys Ther. 2003;26(3):23-29. https://doi.org/10.1519/00139143-200312000-00004
  9. Escolar DM, Henricson EK, Mayhew J, et al. Clinical evaluator reliability for quantitative and manual muscle testing measures of strength in children. Muscle Nerve. 2001;24(6):787-793. https://doi.org/10.1002/mus.1070
  10. Fredericson M, Cookingham CL, Chaudhari AM, et al. Hip abductnr weakness in distance runners with iliotibial band syndrome. Clin J Sport Med. 2000;10(3) :169-175. https://doi.org/10.1097/00042752-200007000-00004
  11. Frese E, Brown M, Norton BJ. Clinical reliability of manual muscle testing. Middle trapezius and gluteus medius muscles. Phys Ther. 1987;67(7):1072-1076. https://doi.org/10.1093/ptj/67.7.1072
  12. Hossain M, Nokes LD. A model of dynamic sacro-iliac joint instability from malrecruitment of gluteus maximus and biceps femoris muscles resulting in low back pain. Med Hypotheses. 2005;65(2):278-281. https://doi.org/10.1016/j.mehy.2005.02.035
  13. Hsieh CY, Phillips RB. Reliability of manual muscle testing with a computerized dynamometer. J Manipulative Physiol Ther. 1990;13(2):72-82.
  14. Hungerford B, Gilleard W, Hodges P. Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spine (Phila Pa 1976). 2003;28(14):1593-1600.
  15. Inman VT. Functional aspects of the abductor muscles of the hip. J Bone Joint Surg Am. 1947;29(3):607-619.
  16. Kankaanpaa M, Taimela S, Laaksooen D, et al. Back and hip extensor fatigability in chronic low back pain patients and controls. Arch Phys Med Rebabil. 1998;79(4):412-417. https://doi.org/10.1016/S0003-9993(98)90142-3
  17. Kendall FP, Provance PG, McCreary EK. Muscles: Testing and function with posture and pain. 4th ed. Baltimore, Williams & Wilkins, 2005.
  18. Li RC, Jasiewicz JM, Middletoo J, et al. The development, validity, and reliability of a manual muscle testing device with integrated limb position sensors. Arch Phys Med Rebabil. 2006;87(3):411-417. https://doi.org/10.1016/j.apmr.2005.11.011
  19. Lu TW, Hsu HC, Chang LY, et al. Enhancing the examiner's resisting force improves the reliability of manual muscle strength measurements: Comparison of a new device with band-held dynamometry. J Rebabil Med. 2007;39(9):679-684.
  20. Maluf KS, Sahrmann SA, Van Dillen LR. Use of a classification system to guide nonsurgical management of a patient with chronic low back pain. Phys Ther. 2000;80(11):1097-1111.
  21. Nadler SF, Malanga GA, Feinberg JH, et al. Relationship between hip muscle imbalance and occurrence of low back pain in collegiate athletes: A prospective study. Am J Phys Med Rehabil. 2001;80(8):572-577. https://doi.org/10.1097/00002060-200108000-00005
  22. Neumann DA. Kinesiology of the Musculoskeletal System: Foundations for physical rehabilitation. St. Louis, Mosby, 2002.
  23. Perry J, Weiss WB, Burnfield JM, et al. The supine hip extensor manual muscle test: A reliability and validity study. Arch Phys Med Rebabil. 2004;85(8):1345-1350. https://doi.org/10.1016/j.apmr.2003.09.019
  24. Phil Page, Clare Frank, Robert Lardner. Assessment and Treatment of Muscle Imbalance: The Janda approach. Champaign, Human Kinetics, 2010.
  25. Pollard H, Lakay B, Tucker F, et al. Interexaminer reliability of the deltoid and psoas muscle test. J Manipulative Physiol Ther. 2005;28(1):52-56. https://doi.org/10.1016/j.jmpt.2004.12.008
  26. Pua YH, Wrigley TV, Cowan SM, et al. Intrarater test-retest reliability of hip range of motion and hip muscle strength measurements in persons with hip osteoarthritis. Arch Phys Med Rebabil. 2008;89(6):1146-1154. https://doi.org/10.1016/j.apmr.2007.10.028
  27. Sahrmann S. Diagnosis and Treatment of Movement Impairment Syndrome. St Louis, Mosby, 2002.
  28. Schmitt WH Jr, Cuthbert SC. Common errors and clinical guidelines for manual muscle testing: the "arm test" and other inaccurate procedures. Chiropr Osteopat. 2008;16:16. https://doi.org/10.1186/1746-1340-16-16
  29. Wadsworth CT, Krishnan R, Sear M, et al. Intrarater reliability of manual muscle testing and band-held dynametric muscle testing. Phys Ther. 1987;67(9):1342-1347. https://doi.org/10.1093/ptj/67.9.1342