Agreement of Manual Muscle Testing and Test-Retest Reliability of Hand Held Dynamometer for the Posterior Gluteus Medius Muscle for Patients With Low Back Pain
The purpose of this study was to assess the agreement of manual muscle testing (MMT) and test-retest reliability of a hand held dynamometer for the posterior gluteus medius muscle, with and without lumbar stabilization, using a pressure biofeedback unit for patients with low back pain. The pressure biofeedback unit was used to minimize the substitute motion of the lumbopelvic region during hip abduction in patients lying on their side. Fifteen patients with low back pain participated in this study. A tester determined the MMT grades of the posterior gluteus medius with and without the pressure biofeedback unit. Active hip abduction range of motion with an inclinometer and the strength of their posterior gluteus medius using a hand held dynamometer were measured with and without the pressure biofeedback unit in the MMT position. The agreement of the grade of muscle strength in the MMT, and intra-rater reliability of both the active hip abduction range of motion and the strength of posterior gluteus medius were analyzed using the weighted kappa and intraclass correlation coefficient (ICC), respectively. The agreement of MMT with the pressure biofeedback unit (weighted kappa=.92) was higher than the MMT (weighted kappa=.34)(p<.05). The inclinometer with pressure biofeedback unit measurement of the active hip abduction range of motion had an excellent intra-rater reliability (ICC=.90). Also, the hand held dynamometer with pressure biofeedback unit measure of strength of the posterior gluteus medius had a good intra-rater reliability (ICC=.85). Therefore, the test for muscle strength with pressure biofeedback unit will be a reliable method for the determination of the MMT grades or amount of posterior gluteus medius muscle strength and the measurement of the range of motion for hip abduction in patients with low back pain.