Background: In the South Korean private insurance sector, manual therapy faces increasing scrutiny, necessitating objective evidence for continued reimbursement. Traditional measurements often lack reproducibility or clinical practicality. Objectives: This study evaluated the feasibility of belt-stabilized hand-held dynamometry (HHD) as an objective tool for documenting strength changes and informing insurance coverage decisions. Design: A two-case clinical report. Methods: Two adult males undergoing post-operative knee rehabilitation with manual therapy were included: (1) ACL reconstruction with medial meniscus injury and (2) ORIF after knee trauma. With participants seated at the table edge and the trunk stabilized by gripping the table, knee flexion was set at 95°. Belt-stabilized HHD was used to measure isometric knee extension and flexion (three trials; maximum value recorded in N). A single examiner (>15 years’ experience) used a standardized protocol across sessions. Results: Case 1 improved from 44% (extension) and 42% (flexion) limb symmetry to 71.4% and 69.6% by session 20, supporting continued care and reimbursement after 30 sessions. Case 2 showed 60.2% extension symmetry at session 20, but subsequent reassessments lacked consistent improvement, contributing to discontinuation. Conclusion: Belt-stabilized HHD may provide a practical, low-cost method to quantify strength changes and support transparent clinician–patient–insurer communication; larger prospective studies are needed.

INTRODUCTION
SUBJECTS AND METHODS
    Study Design
    Subjects
    Muscle Strength Assessment
RESULTS
    Case 1
    Case 2
DISCUSSION
CONCLUSION
FUNDING
CONFLICTS OF INTEREST
AUTHOR CONTRIBUTIONS
REFERENCES

• Ilhyun Kim(Department of Physical Therapy, Yoingin University, Yongin, Republic of Korea)
• Hojung An(Department of Physical Therapy, Dongnam Health University, Suwon, Republic of Korea) Corresponding author
• Junghyun Choi(Department of Physical Therapy, Namseoul University, Cheonan, Republic of Korea)