Background

Stronger toe flexor muscles improve performance outcomes in children, including balance, sprinting, jumping and side stepping. Toe flexor strength (TFS) is recommended as part of the clinical assessment of foot function in children. Fixed dynamometry, rather than handheld, is the gold standard of measurement; however, it can be prohibitively costly. No fixed dynamometer reliability studies on toe flexion have been conducted in children to date.

Research questions

Does the novel fixed hand-held dynamometer (HHD) protocol provide reliable intra-rater and test-retest measurements of toe flexor strength in children aged 10 to 12?

Methods

Two trials were recorded from 14 healthy children (10–12 years), 7–14 days apart by the same rater. A Lafayette HHD (model 01163) measured peak force. The HHD was secured in a mobile custom mould below a step with a strap, which secured the foot of the participant. The receptor pads of the HHD were level with the upper surface of the step, maintaining neutral toe joints at rest. The participant was seated on an adjustable stool to ensure the hip, knee and ankle were each at 90° flexion, with the testing foot flat on the upper surface of the step. The averages of three maximal five second efforts were used for data analysis using a two-way mixed effects model with repeated measures ANOVA (intraclass correlation coefficient ICC 3,3). Standard error of measurement (SEM) was calculated to determine the absolute between trial variability.

Results

The novel fixed HHD protocol provided excellent test-retest reliability with small measurement error for hallux (ICC 3,3 = 0.93, 95 % CI 0.78−0.98, SEM = 4.31 N) and lesser toe flexor strength testing (ICC 3,3 = 0.96, 95 % CI 0.87−0.99, SEM = 1.86 N).

Significance

The fixed HHD protocol described in this study has excellent reliability for the test-retest evaluation of children’s toe flexor strength.

中文翻译：

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新型固定式测力计可实现十至十二岁儿童脚趾强度测量的出色可靠性

背景

较强的脚趾屈肌可以改善儿童的成绩，包括平衡，冲刺，跳跃和侧向踩踏。建议将趾屈肌力量（TFS）作为儿童脚功能临床评估的一部分。固定测功而非手持式测功是测量的金标准；但是，这可能会花费巨大。迄今为止，尚未在儿童中进行有关脚趾屈曲的固定测功机可靠性研究。

研究问题

新颖的固定式手持测功器（HHD）协议是否可以为10至12岁的儿童提供可靠的帧内评估者和重新测试脚趾屈肌强度的方法？

方法

记录了14名健康儿童（10-12岁）的两次试验，同一评分者相隔7-14天。拉斐特HHD（型号01163）测量了峰值力。将HHD用绑带固定在台阶下的可移动定制模具中，绑带固定参与者的脚。HHD的接受垫与台阶的上表面齐平，保持中性脚趾关节静止。参与者坐在可调节的凳子上，以确保臀部，膝盖和脚踝分别屈曲90°，测试脚平放在台阶的上表面。使用具有重复测量方差分析（类内相关系数ICC 3,3）的双向混合效应模型，将三个最大五秒钟努力的平均值用于数据分析。计算标准测量误差（SEM），以确定两次试验之间的绝对差异。

结果

新颖的固定HHD协议提供了出色的重测可靠性，并且对拇指的测量误差很小（ICC 3,3 = 0.93，95％CI 0.78-0.98，SEM = 4.31 N）和较小的脚趾屈肌强度测试（ICC 3,3 = 0.96） ，95％CI 0.87-0.99，SEM = 1.86 N）。

意义

在这项研究中描述的固定HHD协议对于儿童脚趾屈肌力量的重测评估具有出色的可靠性。