Intra-rater reliability of hip abductor isometric strength assessment in older fallers and non-fallers - 26/09/17
Résumé |
Objective |
Impaired muscle function at the hip has been implicated to be a major factor related to falls in older patients. Falls mostly occur in an upright position, therefore, the measurement of hip abductor strength in the often used side-lying or supine position is not functional. The aim was to investigate, for older persons at risk of falls, the feasibility and intra-rater reliability of a hip abductor test in standing position.
Material/Patients and methods |
To be included older persons had to be over 65 years. Fifteen fallers and 15 non-fallers participated in this study. Hip abductor strength was quantified with a hand-held dynamometer in standing position. Three trials were realized for both sessions. The raw force signals were exported and a low-pass filter was applied to attenuate high-frequency noise. The voluntary isometric strength (MVIS) was defined as the peak value reached within 0 to 4s. The rate of force generation (RFG) was evaluated over 50ms after 10% of the MVIS was reached. All variables were normalized for participants’ weight. Reliability was determined using intra-class correlation coefficient (ICCagreement), standard error measurement (SEM) and Bland and Altman plot analysis (mean differences between sessions and limit of agreement-LOA95%). The ICC above 0.75 indicated good reliability, those between 0.5 and 0.75 moderate reliability and those under 0.5, poor reliability.
Results |
All recruited persons completed the strength test in standing position. The intra-rater reliability for MVIS parameter was good in non-fallers group (ICC=0.94, SEM=7.86N) and fallers group (ICC=0.91, SEM=6.36N). The RFG parameter was characterized with a moderate reliability in non-fallers group (ICC=0.63, SEM=114.24N/s) and good reliability in fallers group (ICC=0.83, SEM=71.12N/s). Bland and Altman analysis revealed small mean differences between sessions for MVIS (fallers: 1.41N [LOA95%: −15.56;18.38] vs. non-fallers: 1.97N [LOA95%: −21.26;25.20]) and larger mean differences for RFG (fallers: 44.28N/s [LOA95%: −137.56;226.12] vs. non-fallers: −72.1N/s [LOA95%: −428.60;284.10]).
Discussion/Conclusion |
This standing approach is feasible to measure the hip abductors strength in older persons at risk of falls. Hip abductor strength assessment using a hand-held dynamometer provided consistent results when measured several times. For clinicians, this reliable test is easy to perform in daily use and interesting for testing the hip abductors strengths in a functional position.
Le texte complet de cet article est disponible en PDF.Keywords : Elderly, Falls, Muscle strength, Hip, Abductor, Standing, Reliability
Plan
Vol 60 - N° S
P. e50 - septembre 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.