Muscular strength measurements through hand-held and anchored dynamometry A study of test-retest and interrater reliability
Article Sidebar
Main Article Content
Abstract
Background: Handheld dynamometry (HHD) offers a cost-effective and accessible method for measuring maximal voluntary contraction (MVC) compared to larger fixed dynamometers. This study aimed to determine if fixing the portable HHD device to a support anchor could improve intra- and inter-rater reliability across different muscle groups. Methods: Twelve healthy adults (ages 18–34) participated in two sessions of isometric MVC testing for ten muscle actions, conducted by two raters under both hand-held and anchored conditions. Interrater and intra-rater reliability were evaluated using intraclass correlation coefficients (ICC). Results: The anchored system demonstrated overall excellent interrater reliability (ICC = 0.935), while the hand-held condition yielded good reliability (ICC = 0.895), falling just below the threshold for excellent. Both methods showed overall excellent intra-rater reliability (HHD ICC = 0.933; Anchor ICC = 0.953). The anchored system yielded excellent reliability for elbow extension & flexion, internal & external rotation of the shoulder, plantarflexion, and neck extension, while moderate reliability was observed for knee assessments. Conclusions: Results support the use of anchoring systems to enhance measurement consistency, especially when using multiple raters. Anchored HHD systems may offer a more stable, repeatable method for muscle strength evaluation, benefiting both muscle strength and muscle injury assessments and research protocols.
Downloads
Article Details
Section
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Each author warrants that his or her submission to the Work is original and that he or she has full power to enter into this agreement. Neither this Work nor a similar work has been published elsewhere in any language nor shall be submitted for publication elsewhere while under consideration by Journal of Human Sport and Exercise (JHSE). Each author also accepts that the JHSE will not be held legally responsible for any claims of compensation.
Authors wishing to include figures or text passages that have already been published elsewhere are required to obtain permission from the copyright holder(s) and to include evidence that such permission has been granted when submitting their papers. Any material received without such evidence will be assumed to originate from the authors.
Please include at the end of the acknowledgements a declaration that the experiments comply with the current laws of the country in which they were performed. The editors reserve the right to reject manuscripts that do not comply with the abovementioned requirements. The author(s) will be held responsible for false statements or failure to fulfill the above-mentioned requirements.
This title is licensed under a Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0).
You are free to:
Share — copy and redistribute the material in any medium or format.
Adapt — remix, transform, and build upon the material.
The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
-
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
-
NonCommercial — You may not use the material for commercial purposes.
-
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
- You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
- No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
How to Cite
References
Aerts, F., Sheets, H., Anderson, C., Bussie, N., Hoskins, R., Maninga, A., & Novak, E. (2025). Reliability and agreement of hand-held dynamometry using three standard rater test positions. International Journal of Sports Physical Therapy, 20(2), 243. https://doi.org/10.26603/001c.128286
Alnahdi, A. H., Zeni, J. A., & Snyder-Mackler, L. (2014). Hip abductor strength reliability and association with physical function after unilateral total knee arthroplasty: A cross-sectional study. Physical Therapy, 94(8), 1154-1162. https://doi.org/10.2522/ptj.20130335
Beshay, N., Lam, P. H., & Murrell, G. A. (2011). Assessing the reliability of shoulder strength measurement: Hand-held versus fixed dynamometry. Shoulder & Elbow, 3(4), 244-251. https://doi.org/10.1111/j.1758-5740.2011.00137.x
Bohannon, R. W., Kindig, J., Sabo, G., Duni, A. E., & Cram, P. (2012). Isometric knee extension force measured using a hand-held dynamometer with and without belt-stabilization. Physiotherapy Theory and Practice, 28(7), 562-568. https://doi.org/10.3109/09593985.2011.640385
Bohannon, R. W. (2021). Characterization of muscle strength using the strength domain of the stroke impact scale: An integrative review. Isokinetics and Exercise Science, 29(3), 219-231. https://doi.org/10.3233/IES-210101
Byram, I. R., Bushnell, B. D., Dugger, K., Charron, K., Harrell, F. E., & Noonan, T. J. (2010). Preseason shoulder strength measurements in professional baseball pitchers: Identifying players at risk for injury. American Journal of Sports Medicine, 38(7), 1375-1382. https://doi.org/10.1177/0363546509360404
Byrne, A., Lodge, C., & Wallace, J. (2020). Intrarater test-retest reliability of hip abduction, internal rotation, and external rotation strength measurements in a healthy cohort using a hand-held dynamometer and a portable stabilization device: A pilot study. Archives of Rehabilitation Research and Clinical Translation, 2(2), 100050. https://doi.org/10.1016/j.arrct.2020.100050
Cibulka, M. T., Herren, J., Kilian, A., Smith, S., Mahmutovic, F., & Dolles, C. (2017). The reliability of assessing sternocleidomastoid muscle length and strength in adults with and without mild neck pain. Physiotherapy Theory and Practice, 33(4), 323-330. https://doi.org/10.1080/09593985.2017.1302539
Conceição, A., Parraca, J., Marinho, D., Costa, M., Louro, H., Silva, A., et al. (2018). Assessment of isometric strength of the shoulder rotators in swimmers using a hand-held dynamometer: A reliability study. Acta of Bioengineering and Biomechanics, 20(4), 119-127.
Croteau, F., Robbins, S. M., & Pearsall, D. (2021). Hand-held shoulder strength measures correlate with isokinetic dynamometry in elite water polo players. Journal of Sport Rehabilitation, 30(8), 1233-1238. https://doi.org/10.1123/jsr.2020-0277
Davis, P. R., McKay, M. J., Baldwin, J. N., Burns, J., Pareyson, D., & Rose, K. J. (2017). Repeatability, consistency, and accuracy of hand-held dynamometry with and without fixation for measuring ankle plantarflexion strength in healthy adolescents and adults. Muscle & Nerve, 56(5), 896-900. https://doi.org/10.1002/mus.25576
Dollings, H., Sandford, F., O'Conaire, E., & Lewis, J. S. (2012). Shoulder strength testing: The intra- and inter-tester reliability of routine clinical tests, using the PowerTrack™ II Commander. Shoulder & Elbow, 4(2), 131-140. https://doi.org/10.1111/j.1758-5740.2011.00162.x
Eriksrud, O., & Bohannon, R. W. (2003). Relationship of knee extension force to independence in sit-to-stand performance in patients receiving acute rehabilitation. Physical Therapy, 83(6), 544-551. https://doi.org/10.1093/ptj/83.6.544
Fieseler, G., Molitor, T., Irlenbusch, L., Delank, K. S., Laudner, K. G., Hermassi, S., et al. (2015). Intrarater reliability of goniometry and hand-held dynamometry for shoulder and elbow examinations in female team handball athletes and asymptomatic volunteers. Archives of Orthopaedic and Trauma Surgery, 135(12), 1719-1726. https://doi.org/10.1007/s00402-015-2331-6
García-Hermoso, A., Cavero-Redondo, I., Ramírez-Vélez, R., Ruiz, J. R., Ortega, F. B., Lee, D. C., et al. (2018). Muscular strength as a predictor of all-cause mortality in an apparently healthy population: A systematic review and meta-analysis of data from approximately 2 million men and women. Archives of Physical Medicine and Rehabilitation, 99(10), 2100-2113. https://doi.org/10.1016/j.apmr.2018.01.008
Gordon, A. M., Huxley, A. F., & Julian, F. J. (1966). The variation in isometric tension with sarcomere length in vertebrate muscle fibres. Journal of Physiology, 184(1), 170-192. https://doi.org/10.1113/jphysiol.1966.sp007909
Grootswagers, P., Vaes, A. M. M., Hangelbroek, R., Tieland, M., van Loon, L. J. C., & de Groot, L. C. P. G. M. (2022). Relative validity and reliability of isometric lower extremity strength assessment in older adults by using a hand-held dynamometer. Sports Health, 14(6), 899-905. https://doi.org/10.1177/19417381211063847
Hams, A. H., Evans, K., Adams, R., Waddington, G., & Witchalls, J. (2019). Shoulder internal and external rotation strength and prediction of subsequent injury in water-polo players. Scandinavian Journal of Medicine & Science in Sports, 29(9), 1414-1420. https://doi.org/10.1111/sms.13459
Hartmann, A., Knols, R., Murer, K., & De Bruin, E. D. (2009). Reproducibility of an isokinetic strength-testing protocol of the knee and ankle in older adults. Gerontology, 55(3), 259-268. https://doi.org/10.1159/000172832
Holt, K. L., Raper, D. P., Boettcher, C. E., Waddington, G. S., & Drew, M. K. (2016). Hand-held dynamometry strength measures for internal and external rotation demonstrate superior reliability, lower minimal detectable change and higher correlation to isokinetic dynamometry than externally-fixed dynamometry of the shoulder. Physical Therapy in Sport, 21, 75-81. https://doi.org/10.1016/j.ptsp.2016.07.001
Johansson, K. M., & Adolfsson, L. E. (2005). Intraobserver and interobserver reliability for the strength test in the Constant-Murley shoulder assessment. Journal of Shoulder and Elbow Surgery, 14(3), 273-278. https://doi.org/10.1016/j.jse.2004.08.001
Kelln, B. M., McKeon, P. O., Gontkof, L. M., & Hertel, J. (2008). Hand-held dynamometry: Reliability of lower extremity muscle testing in healthy, physically active, young adults. Journal of Sport Rehabilitation, 17(2), 160-170. https://doi.org/10.1123/jsr.17.2.160
Koo, T. K., & Li, M. Y. (2016). A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of Chiropractic Medicine, 15(2), 155-163. https://doi.org/10.1016/j.jcm.2016.02.012
Katoh, M., & Yamasaki, H. (2009). Comparison of reliability of isometric leg muscle strength measurements made using a hand-held dynamometer with and without a restraining belt. Journal of Physical Therapy Science, 21(1), 37-42. https://doi.org/10.1589/jpts.21.37
Marmon, A. R., Pozzi, F., & Alnahdi, A. H. (2013). The validity of plantarflexor strength measures obtained through hand‐held dynamometry measurements of force. International Journal of Sports Physical Therapy, 8(6), 820-827.
Mentiplay, B. F., Perraton, L. G., Bower, K. J., Adair, B., Pua, Y. H., Williams, G. P., McGaw, R., & Clark, R. A. (2015). Assessment of lower limb muscle strength and power using hand-held and fixed dynamometry: A reliability and validity study. PLoS ONE, 10(10), e0140822. https://doi.org/10.1371/journal.pone.0140822
Shahidi, B., Johnson, C. L., Curran-Everett, D., & Maluf, K. S. (2012). Reliability and group differences in quantitative cervicothoracic measures among individuals with and without chronic neck pain. BMC Musculoskeletal Disorders, 13, 1. https://doi.org/10.1186/1471-2474-13-215
Thorborg, K., Bandholm, T., Schick, M., Jensen, J., & Hölmich, P. (2013). Hip strength assessment using hand-held dynamometry is subject to intertester bias when testers are of different sex and strength. Scandinavian Journal of Medicine & Science in Sports, 23(4), 487-493. https://doi.org/10.1111/j.1600-0838.2011.01405.x
Whiteley, R., Jacobsen, P., Prior, S., Skazalski, C., Otten, R., & Johnson, A. (2012). Correlation of isokinetic and novel hand-held dynamometry measures of knee flexion and extension strength testing. Journal of Science and Medicine in Sport, 15(5), 444-450. https://doi.org/10.1016/j.jsams.2012.01.003
Wikholm, J. B., & Bohannon, R. W. (1991). Hand-held dynamometer measurements: Tester strength makes a difference. Journal of Orthopaedic & Sports Physical Therapy, 13(4), 191-198. https://doi.org/10.2519/jospt.1991.13.4.191
Yusuf, S., Joseph, P., Rangarajan, S., Islam, S., Mente, A., Hystad, P., et al. (2020). Modifiable risk factors, cardiovascular disease, and mortality in 155,722 individuals from 21 high-, middle-, and low-income countries. The Lancet, 395(10226), 795-808. https://doi.org/10.1016/S0140-6736(19)32008-2