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Minimal Detectable Change in Quadriceps Strength and Voluntary Muscle Activation in Patients With Knee Osteoarthritis
Authors:Crystal O. Kean  Trevor B. Birmingham  S. Jayne Garland  Dianne M. Bryant  J. Robert Giffin
Affiliation:a Wolf Orthopaedic Biomechanics Laboratory, University of Western Ontario, London, ON, Canada
b School of Physical Therapy, University of Western Ontario, London, ON, Canada
c Department of Surgery, Schulich School of Medicine, University of Western Ontario, London, ON, Canada
d Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
Abstract:Kean CO, Birmingham TB, Garland SJ, Bryant DM, Giffin JR. Minimal detectable change in quadriceps strength and voluntary muscle activation in patients with knee osteoarthritis.

Objective

To examine the test-retest reliability and quantify the minimal detectable change (MDC) in quadriceps strength and voluntary activation in patients with knee osteoarthritis (OA).

Design

Repeated measures over a 1-week interval.

Setting

Tertiary care center.

Participants

A convenience sample of patients (N=20) diagnosed with knee OA.

Intervention

Isokinetic and isometric quadriceps strength testing and voluntary quadriceps activation testing using interpolated twitch technique.

Main Outcome Measures

Peak isokinetic and isometric knee extension torque (Nm) and percentage of voluntary quadriceps activation (%).

Results

The mean differences with 95% confidence intervals between the 2 test sessions for quadriceps isokinetic strength, isometric strength, and percent of voluntary activation were −4.34Nm (−14.01 to 5.34Nm), 1.56Nm (−5.56 to 8.68Nm), and 1.34% (−.53 to 3.22%), respectively. The intraclass correlation coefficients for all measures ranged from .93 to .98. The standard errors of measurement (SEMs) for quadriceps isokinetic and isometric strength were 14.57Nm and 10.76Nm, respectively. The SEM for percentage of voluntary activation was 2.84%. Based on these values, the MDCs were 33.90Nm, 25.02Nm, and 6.60% for quadriceps isokinetic strength, isometric strength, and percentage of voluntary activation, respectively.

Conclusions

Maximal quadriceps isokinetic strength, isometric strength, and percentage of voluntary activation measures demonstrate excellent test-retest reliability in patients with knee OA. In addition to research applications, the present findings suggest these measures are appropriate for use when evaluating change in neuromuscular function of the quadriceps in individual patients.
Keywords:Muscle strength   Osteoarthritis, knee   Rehabilitation
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