Zanesljivost in veljavnost ročne dinamometrije na spodnjem udu pri zdravih ljudeh ter njena povezanost z algometrijo s pritiskom : magistrsko delo

Lipovšek, Tjaša (author), Puh, Urška (mentor), Kacin, Alan (comentor)

Uvod: Ročna dinamometrija združuje nekaj prednosti tako manualnega testiranja mišic kot testiranja s fiksnim dinamometrom. Posledično se za ocenjevanje mišične sile ročni dinamometri v klinični praksi vedno bolj uporabljajo, vendar je standardizacija testnih postopkov pomanjkljiva. Za merjenje občutljivosti na s pritiskom povzročeno bolečino, so najpogosteje v uporabi algometri na pritisk. Namen: Oceniti zanesljivost in veljavnost postopka ročne dinamometrije in zanesljivost postopka algometrije s pritiskom na spodnjem udu pri zdravih preiskovancih. Preveriti povezanost mišične sile in praga bolečine na pritisk. Metode: V raziskavo je bilo vključenih 30 zdravih mladih odraslih. Preiskovanci so se udeležili dveh testiranj ročne dinamometrije in algometrije s pritiskom v razmiku dveh dni. Vsakič smo izmerili mišično silo 12 mišičnih skupin spodnjega uda in prag bolečine na pritisk nad m. rectus femoris in m. tibialis anterior. Zanesljivost posameznega preiskovalca smo ocenili z intraklasnimi koeficienti korelacije. Za primerjavo največje meritve in povprečja meritev, kot možnih izidov, smo izvedli parni test t ter izračunali standardno napako merjenja (SEM). Na drugem testiranju smo izvedli tudi meritve sile mišičnih skupin kolenskega sklepa na fiksnem dinamometru. Kriterijsko veljavnost ročne dinamometrije v primerjavi s fiksno in povezanost med mišično silo ter pragom bolečine na pritisk smo ocenili s Pearsonovimi koeficienti korelacije. Rezultati: Zanesljivost posameznega preiskovalca za ročno dinamometrijo je bila visoka do odlična (ICC = 0,79-0,96) in algometrije s pritiskom odlična (ICC = 0,94-0,97). Razlike med izidi največje meritve in povprečja meritev so bile statistično značilne tako pri ročni dinamometriji kot pri algometriji s pritiskom. Pri ročni dinamometriji je bila SEM večinoma nižja pri povprečju meritev, medtem ko so bile pri algometriji s pritiskom razlike v SEM med izidi zanemarljive. Kriterijska veljavnost ročne dinamometrije v primerjavi s fiksno je bila dobra do odlična (r = 0,65-0,89). Prag bolečine na pritisk nad m. rectus femoris je bil pozitivno povezan z mišično silo ekstenzorjev kolena, vendar je bila korelacija slaba (r = 0,38-0,46). Povezanost med pragom bolečine na pritisk nad m. tibialis anterior in mišično silo dorzalnih fleksorjev ni bila statistično značilna. Zaključki: Uporabljeni postopek ročne dinamometrije je zanesljiv in veljaven za merjenje mišične sile spodnjih udov pri zdravih preiskovancih. Z algometrijo s pritiskom lahko zanesljivo ocenimo prag bolečine na pritisk. Kot izid meritev pri obeh postopkih svetujemo uporabo povprečja dveh meritev. Povezanost med pragom bolečine na pritisk nad m. rectus femoris in silo mišic ekstenzorjev kolena je slaba. Pri zdravih ljudeh je potrebno preveriti tudi zanesljivost med preiskovalci, poleg tega pa za namen uporabe v kliničnem okolju preveriti merske lastnosti ročne dinamometrije in algometrije s pritiskom pri pacientih.

• Language: Slovenian
• Keywords: meritve mišične sile, meritve občutljivosti na pritisk, merske lastnosti
• Work type: Master's thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2019
• PID: 20.500.12556/RUL-108316
• COBISS.SI-ID: 5646699
• Publication date in RUL: 28.06.2019

Secondary language

• Language: English
• Title: Reliability and validity of hand-held dynamometry in the lower extremity and its correlation with pressure algometry in healthy people : master thesis

Abstract

Introduction: Hand-held dynamometry combines some of the advantages of both manual muscle testing and fixed dynamometry. Although there is a lack of standardized testing protocols in the literature, they are increasingly being used in clinical practice for obtaining measures of muscle strength. Pressure algometers are commonly being used to measure mechanical pain sensitivity. Purpose: To examine the reliability and validity of hand-held dynamometry as well as the reliability of pressure algometry in the lower extremity of healthy subjects. To investigate association between muscle strength and pressure pain sensitivity. Methods: 30 healthy young adults were included in the study. Hand-held dynamometry and pressure algometry testing procedures were performed twice. Muscle strength of 12 lower extremity muscle groups and pressure pain threshold at the m. rectus femoris and m. tibialis anterior were measured. Testing sessions were separated by two days. Assessment of intra-rater reliability was conducted using intraclass correlation coefficients. Paired t-test was performed and standard errors of measurement (SEM) were calculated for comparison of two possible outcome choices: best value and the average of two trials. A criterion-reference fixed dynamometer was used on the second testing session for testing muscle strength of knee joint muscle groups. Criterion validity of hand-held dynamometry and association between pressure pain sensitivity and muscle strength was assessed with Pearson correlation coefficients. Results: Intra-rater reliability of hand-held dynamometry was good to excellent (ICC = 0.79-0.96) and of pressure algometry excellent (ICC = 0.94-0.97). Differences between the two methods of selecting the outcome were statistically significant in both measuring procedures. For hand-held dynamometry lower SEM was mostly calculated for the average of two trials, while for pressure algometry the differences in SEM between the two outcome choices were negligible. Criterion validity of hand-held dynamometry was good to excellent (r = 0.65-0.89). Pressure pain threshold at the m. rectus femoris was positively associated with knee extensors muscle strength, but the correlation was low (r = 0.38-0.46). Association between pressure pain threshold at the m. tibialis anterior and dorsal flexors muscle strength was not statistically significant. Conclusions: Hand-held dynamometry is a reliable and valid measuring procedure for assessment of lower extremity muscle strength in healthy subjects. Pressure pain threshold can be reliably assessed with pressure algometry. For result of both testing procedures we recommend to use an average of two trials. Association between the pressure pain threshold at the m. rectus femoris and the knee extensors muscle strength is fair. Future research should examine inter-rater reliability of these procedures in healthy subjects as well as examine measurement properties in clinical populations.

• Keywords: muscle strength measurements, pressure pain sensitivity measurements, measurement properties