The reliability and validity of handheld dynamometry for the measurement of lower-extremity muscle strength in older adults.

Lower-extremity muscle strength is important in predicting fall risk in older adults. Handheld dynamometry (HHD) is a tool used to measure isometric muscle strength in the older adult, but few studies have evaluated the utility of HHD for muscle groups beyond knee extension. The purpose of this study was to evaluate the reliability of HHD at the hip, knee, and ankle and to compare HHD strength values to other isometric dynamometry (ID) and to balance and recovery in older adults. This was a repeated measures study design of 18 men and women, age 65 to 92 years of age, who had HHD strength testing 3 to 7 days apart by the same examiner and repeat testing on the same day using 2 independent examiners. ID strength, balance, step length, and reaction time were measured once. HHD demonstrated good intrarater and interrater reliability for isometric strength at the hip and knee but was not a reliable measure for ankle strength. The HHD was a valid measure of isometric strength at the hip and knee, demonstrating moderate to high correlation values when compared to ID strength measures (r = 0.57-0.86; p < 0.05). Hip and knee strength was positively associated to step length and reaction time but not to balance (r = 0.40-0.71; p < 0.05). In conclusion, HHD is a reliable and valid assessment tool for measuring strength at the hip and knee in older adults, and greater strength in these muscles is associated with longer step length and decreased reaction time, which are important components of balance recovery in older adults. HHD can be used as an effective strength measurement tool for the older adult population.