Lower Extremity Handheld Dynamometry Strength Measurement in Children With Cerebral Palsy

Purpose: The purpose of this study was to evaluate the evidence on reliability of handheld dynamometry protocols to quantify maximal isometric strength of the muscles of the lower extremities of children with cerebral palsy. Methods: A systematic search of Cochrane, MEDLINE, CINAHL, and PubMed up to December 2013 and best-evidence synthesis were performed. Results: Seven eligible studies were identified. Best-evidence synthesis revealed "unknown" to "moderate" evidence. Intraclass correlation coefficient values were "positive" for most muscle groups for intrarater reliability and showed mixed results for interrater reliability. Conclusions: Because of small sample sizes (10-25) in all included studies, the final level of evidence remains "unknown." Reliability data obtained in the included studies of handheld dynamometry in children with cerebral palsy are promising, despite low levels of evidence. When these protocols are applied very carefully, they may prove relevant to different clinical settings.