Reliability and agreement of isometric functional trunk and isolated lumbar strength assessment in healthy persons and persons with chronic nonspecific low back pain

Objectives: to assess intra/inter-operator reliability and agreement of maximum isometric abdominal and back muscle strength in a functional trunk and isolated lumbar protocol, using an isokinetic dynamometer, in healthy persons and persons with chronic nonspecific low back pain (CNSLBP).

Design: Test-retest.

Setting: Participants performed two assessments consisting of two protocols on the Biodex 3 system, evaluating maximum isometric back and abdominal strength in a functional trunk and isolated lumbar position. During the first assessment, each protocol was executed twice, supported by different operators.

Participants: Healthy persons (n = 20) and persons with CNSLBP (n = 20).

Main outcome measures: Intraclass Correlation (ICC), Standard Error of Measurement (SEM and %SEM), and Minimal Detectable Change (MDC) of muscle strength outcomes and seat positioning characteristics were calculated.

Results: Intra/inter reliability of muscle strength outcomes was excellent (ICC: 0.94-0.98), while seat positioning characteristics varied from low to high (ICC: 0-0.94). For muscle strength outcomes, %SEM ranged from 4.7 to 9.2% and MDC ranged from 14.3 to 29.8 Nm in trunk flexion and 39.1-68.5 Nm in trunk extension.

Conclusions: The Biodex 3 system can be used reliably to assess maximum isometric trunk muscle strength with the aforementioned protocols in healthy persons and persons with CNSLBP. All muscle strength outcomes showed comparable agreement (%SEM < 10%).