MEASURE RIGHT: DEVELOPMENT OF A UNIFIED HAND-HELD DYNAMOMETRY PROTOCOL FOR CHRONIC STROKE LOWER LIMB MUSCLE TESTING

Abstract

Background: Lower-limb muscle weakness in individuals with chronic stroke significantly limits gait, balance, and functional mobility. Accurate strength assessment is essential; however, existing handheld dynamometry (HHD) protocols lack stroke-specific standardization. Methods: A unified, stroke-specific HHD protocol was developed using standardized positioning, stabilization, and dynamometer placement for eight lower-limb muscle groups. Thirty-one individuals with chronic stroke (19 males, 12 females) were assessed. Intra-rater reliability was evaluated across two consecutive days by the same examiner, and inter-rater reliability was assessed on the same day by two trained physiotherapists using intraclass correlation coefficients (ICC). Results: All muscle groups demonstrated excellent intra- and inter-rater reliability (ICC > 0.90). Predictable pathology-specific weakness and age-related clustering of strength values were observed. Conclusion: The developed HHD protocol is reliable, stroke-specific, and clinically feasible for lowerlimb strength assessment in chronic stroke.