Abstract
Summary
An appropriate method to assess back extensor strength in clinical practice has not yet been described. Our results showed that a hand-held dynamometry fixated with a tripod is reliable for assessing back extensor strength in women with osteoporosis.
Introduction
Back strengthening exercises play an important role in the rehabilitation of patients with osteoporotic vertebral fractures. Evaluation of the effect of back strengthening exercises requires a method suitable for use in clinical practice to measure back extensor strength. A hand-held dynamometer (HHD) is quick and easy to handle in clinical practice. Currently, there is a lack of evidence whether a HHD is reliable for assessment of back extensor strength in people with osteoporosis. When using a HHD, it may be difficult for the tester to provide a counter pressure corresponding to the effort of the patient. In order to accommodate this, we have developed a tripod and a belt system, which was used to fixate the HHD. This study examined the intra-tester reliability of back extensor strength assessment in women with osteoporosis using a HHD.
Methods
Back extensor strength of the participants was measured on two events with 7-day intervals. Test procedures were standardized, and all tests were performed by the same tester.
Results
Forty-eight women with osteoporosis and vertebral fractures were included in the analysis. The coefficient of variation was 22 % using a HHD fixated by the tester and 17 % using a HHD fixated with the tripod. ICC was 0.75 (95 % confidence interval (CI), 0.63 and 0.88) when using a HHD with fixated by the tester and 0.90 (95 % CI, 0.84 and 0.95) when using a HHD fixated with the tripod.
Conclusion
A HHD fixated with a tripod is reliable for the assessment of back extensor strength in women with osteoporosis and vertebral fractures.
Similar content being viewed by others
References
Miyakoshi N, Hongo M, Maekawa S, Ishikawa Y, Shimada Y, Itoi E (2007) Back extensor strength and lumbar spinal mobility are predictors of quality of life in patients with postmenopausal osteoporosis. Osteoporos Int 18:1397–1403
Granito RN, Aveiro MC, Renno AC, Oishi J, Driusso P (2012) Comparison of thoracic kyphosis degree, trunk muscle strength and joint position sense among healthy and osteoporotic elderly women: a cross-sectional preliminary study. Arch Gerontol Geriatr 54:e199–e202
Leidig-Bruckner G, Minne HW, Schlaich C, Wagner G, Scheidt-Nave C, Bruckner T, Gebest HJ, Ziegler R (1997) Clinical grading of spinal osteoporosis: quality of life components and spinal deformity in women with chronic low back pain and women with vertebral osteoporosis. J Bone Miner Res 12:663–675
Ryan SD, Fried LP (1997) The impact of kyphosis on daily functioning. J Am Geriatr Soc 45:1479–1486
Cortet B, Houvenagel E, Puisieux F, Roches E, Garnier P, Delcambre B (1999) Spinal curvatures and quality of life in women with vertebral fractures secondary to osteoporosis. Spine (Phila Pa 1976) 24:1921–1925
van Schoor NM, Smit JH, Twisk JW, Lips P (2005) Impact of vertebral deformities, osteoarthritis, and other chronic diseases on quality of life: a population-based study. Osteoporos Int 16:749–756
Hallberg I, Rosenqvist AM, Kartous L, Lofman O, Wahlstrom O, Toss G (2004) Health-related quality of life after osteoporotic fractures. Osteoporos Int 15:834–841
Schlaich C, Minne HW, Bruckner T, Wagner G, Gebest HJ, Grunze M, Ziegler R, Leidig-Bruckner G (1998) Reduced pulmonary function in patients with spinal osteoporotic fractures. Osteoporos Int 8:261–267
Lynn SG, Sinaki M, Westerlind KC (1997) Balance characteristics of persons with osteoporosis. Arch Phys Med Rehabil 78:273–277
Ishikawa Y, Miyakoshi N, Kasukawa Y, Hongo M, Shimada Y (2009) Spinal curvature and postural balance in patients with osteoporosis. Osteoporos Int 20:2049–2053
Ishikawa Y, Miyakoshi N, Kasukawa Y, Hongo M, Shimada Y (2012) Spinal sagittal contour affecting falls: cut-off value of the lumbar spine for falls. Gait Posture
Sinaki M (2012) Exercise for patients with osteoporosis: management of vertebral compression fractures and trunk strengthening for fall prevention. PM R 4:882–888
Sinaki M, Wollan PC, Scott RW, Gelczer RK (1996) Can strong back extensors prevent vertebral fractures in women with osteoporosis? Mayo Clin Proc 71:951–956
Mika A, Unnithan VB, Mika P (2005) Differences in thoracic kyphosis and in back muscle strength in women with bone loss due to osteoporosis. Spine (Phila Pa 1976) 30:241–246
Sinaki M, Limburg PJ, Wollan PC, Rogers JW, Murtaugh PA (1996) Correlation of trunk muscle strength with age in children 5 to 18 years old. Mayo Clin Proc 71:1047–1054
Ettinger B, Black DM, Nevitt MC, Rundle AC, Cauley JA, Cummings SR, Genant HK (1992) Contribution of vertebral deformities to chronic back pain and disability. The Study of Osteoporotic Fractures Research Group. J Bone Miner Res 7:449–456
Miyakoshi N, Hongo M, Maekawa S, Ishikawa Y, Shimada Y, Okada K, Itoi E (2005) Factors related to spinal mobility in patients with postmenopausal osteoporosis. Osteoporos Int 16:1871–1874
Pfeifer M, Sinaki M, Geusens P, Boonen S, Preisinger E, Minne HW, ASBMR Working Group on Musculoskeletal Rehabilitation (2004) Musculoskeletal rehabilitation in osteoporosis: a review. J Bone Miner Res 19:1208–1214
Pfeifer M, Begerow B, Minne HW (2004) Effects of a new spinal orthosis on posture, trunk strength, and quality of life in women with postmenopausal osteoporosis: a randomized trial. Am J Phys Med Rehabil 83:177–186
Pfeifer M, Kohlwey L, Begerow B, Minne HW (2011) Effects of two newly developed spinal orthoses on trunk muscle strength, posture, and quality-of-life in women with postmenopausal osteoporosis: a randomized trial. Am J Phys Med Rehabil 90:805–815
Sinaki M, Brey RH, Hughes CA, Larson DR, Kaufman KR (2005) Balance disorder and increased risk of falls in osteoporosis and kyphosis: significance of kyphotic posture and muscle strength. Osteoporos Int 16:1004–1010
Sinaki M, Itoi E, Wahner HW, Wollan P, Gelzcer R, Mullan BP, Collins DA, Hodgson SF (2002) Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women. Bone 30:836–841
Borgo M, Sinaki M (2010) Back progressive resistive exercise program to reduce risk of vertebral fractures. J Mineralstoffwechsel 17:66–71
Limburg PJ, Sinaki M, Rogers JW, Caskey PE, Pierskalla BK (1991) A useful technique for measurement of back strength in osteoporotic and elderly patients. Mayo Clin Proc 66:39–44
Hongo M, Itoi E, Sinaki M, Miyakoshi N, Shimada Y, Maekawa S, Okada K, Mizutani Y (2007) Effect of low-intensity back exercise on quality of life and back extensor strength in patients with osteoporosis: a randomized controlled trial. Osteoporos Int 18:1389–1395
Bandholm T, Thorborg K (2010) Måling af muskelstyrke i klinisk praksis. Fysioterapeuten Årg. 92, nr. 12 (2010):10-12 14-20
Stark T, Walker B, Phillips JK, Fejer R, Beck R (2011) Hand-held dynamometry correlation with the gold standard isokinetic dynamometry: a systematic review. PM R 3:472–479
Kolber MJ, Cleland JA (2005) Strength testing using hand-held dynamometry. Phys Ther Rev 10:99–112
Moreland J, Finch E, Stratford P, Balsor B, Gill C (1997) Interrater reliability of six tests of trunk muscle function and endurance. J Orthop Sports Phys Ther 26:200–208
Thorborg K, Bandholm T, Holmich P (2013) Hip- and knee-strength assessments using a hand-held dynamometer with external belt-fixation are inter-tester reliable. Knee Surg Sports Traumatol Arthrosc 21:550–555
Kramer JF, Vaz MD, Vandervoort AA (1991) Reliability of isometric hip abductor torques during examiner- and belt-resisted tests. J Gerontol 46:M47–M51
Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC (2010) The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res 19:539–549
Valentin GH, Pedersen LN, Maribo T (2013) Wearing an active spinal orthosis improves back extensor strength in women with osteoporotic vertebral fractures. Prosthet Orthot Int
Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, Bouter LM, de Vet HC (2010) The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol 63:737
Sinaki M, Brey RH, Hughes CA, Larson DR, Kaufman KR (2005) Significant reduction in risk of falls and back pain in osteoporotic-kyphotic women through a Spinal Proprioceptive Extension Exercise Dynamic (SPEED) program. Mayo Clin Proc 80:849–855
Innes E, Straker L (1999) Reliability of work-related assessments. Work 13:107–124
Atkinson G, Nevill AM (1998) Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine. Sports Med 26:217–238
Weir JP (2005) Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res 19:231–240
Hopkins WG (2000) Measures of reliability in sports medicine and science. Sports Med 30:1–15
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Valentin, G., Maribo, T. Hand-held dynamometry fixated with a tripod is reliable for assessment of back extensor strength in women with osteoporosis. Osteoporos Int 25, 2143–2149 (2014). https://doi.org/10.1007/s00198-014-2743-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00198-014-2743-0