{"id":10414,"date":"2023-02-20T06:00:32","date_gmt":"2023-02-20T05:00:32","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=10414"},"modified":"2023-02-20T19:00:46","modified_gmt":"2023-02-20T18:00:46","slug":"which-muscle-strength-tests-for-knee-extensors-and-flexors-should-we-use-after-an-acl-or-meniscal-injury","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2023\/02\/20\/which-muscle-strength-tests-for-knee-extensors-and-flexors-should-we-use-after-an-acl-or-meniscal-injury\/","title":{"rendered":"Which muscle strength tests for knee extensors and flexors should we use after an ACL or meniscal injury?"},"content":{"rendered":"

Keywords: <\/b>Anterior cruciate ligament, Muscle function, Psychometric properties<\/span><\/p>\n

Anterior Cruciate Ligament (ACL) tears and meniscal injuries lead to knee extensor and flexor muscle weakness. If these strength deficits persist, they increase the risk of re-injury and\/or early development of knee osteoarthritis. For this reason, it is important to monitor muscle strength after these injuries. Currently, there are no recommendations for what is the best way to do this. To explore this topic, the international <\/span>OPTIKNEE<\/span><\/a> team synthesized the current evidence and conducted a consensus exercise. As part of this <\/span>process<\/span><\/a>, we conducted a <\/span>systematic review<\/span><\/a> that assessed the measurement properties of existing muscle strength tests that are used with persons that have an ACL or meniscal injury.<\/span>1<\/span><\/p>\n


\n<\/span>Why is this study important?<\/b><\/p>\n

There are many ways to test knee extensor and flexor strength after an ACL or meniscal injury. The \u2018best\u2019 choice depends on type or mode of test (e.g., isometric, isotonic, isokinetic), available equipment (e.g., dynamometer or free weights), outcome being measured (e.g., Newtons, Newton-meter, Newton-meter\/kilogram), and\u00a0 measurement properties – the one that gives the most precise and accurate results. To assist with choosing tests our systematic review assessed the measurement properties of existing strength test to provide the highest level of evidence.<\/span><\/p>\n


\n<\/b>What did we do?<\/b><\/p>\n

We searched four databases for studies that evaluated measurement properties of knee extensor and flexor strength tests in people with ACL and\/or meniscal injuries with a mean injury age of \u226430 years. The measurement properties we were interest in included: reliability (i.e., produces the same every time and across testers), measurement error (i.e., error not attributed to true change), validity (i.e., measures what it intends to), and responsiveness (i.e., detects change over time).<\/span>2<\/span><\/p>\n

We followed guidelines developed by the international COSMIN initiative<\/span>3<\/span> to assess the risk of bias of each study that assessed at least one measurement property for a knee extensor and flexor strength test. For each measurement property of each test, we synthesised values, graded the evidence, and reached a conclusion (including evidence level).<\/span>4<\/span><\/p>\n

 <\/p>\n

What did we find?<\/b><\/p>\n

Across the 36 studies included in our review we found a large variability in the type or mode of strength test, equipment used, and outcome (e.g., Newtons, Newton-meters, Newton-meters\/kilogram) reported. High-quality studies were scarce. Table 1 summarises the measurement properties per strength test category.<\/span><\/p>\n