Reliability and Validity of a Novel Wearable Device for Measuring Elbow Strength

Abstract

Muscle strength is an important clinical outcome in rehabilitation and sport medicine, but options are limited to expensive but accurate isokinetic dynamometry (IKD) or inexpensive but less accurate hand-held dynamometers (HHD). A wearable, self-stabilizing, limb strength measurement device (LSMD) was developed to fill the current gap in portable strength measurement devices. The purpose of this study was to evaluate the reliability and validity of the LSMD in healthy adults. Twenty healthy adults were recruited to attend two strength testing sessions where elbow flexor and extensor strength was measured with the LSMD, with HHD and with IKD in random order, by two raters. Outcomes were intra-rater repeatability, inter-rater reproducibility and inter-session reproducibility using intra-class correlation coefficients (ICC). Limits of agreement and weighted least products regression were used to test the validity of the LSMD relative to the criterion standard (IKD), and calibration formulas derived to improve measurement fidelity. ICC values for the LSMD were >0.90 for all measures of reliability and for both muscle groups, but over-predicted extensor strength and under-predicted flexor strength. Validity was established by transforming the data with the criterion standard-based calibration. These data indicate that the LSMD is reliable and conditionally valid for quantifying strength of elbow flexors and extensors in a healthy adult population.