Confiabilidade do teste do esfigmomanômetro modificado e não modificado para avaliação de força muscular dos membros inferiores de crianças e adolescentes

Abstract

Quantifying muscle strength allows you to create assertive therapeutic goals. In children and adolescents, most studies use the handheld or isokinetic dynamometer. However, to date, none have investigated the different forms of operationalization and measurement properties with the unmodified and modified sphygmomanometer test (MST) in this population. Thus, to investigate the best way to operationalize the measures (first measure, average of the first two, of the three measures and maximum value among the three measures) for assessing lower limb muscle strength (lower limbs); and to test-retest reliability and inter-examiner values with modified and unmodified MST for different measurements in healthy children and adolescents, aged between six and 19 years. This is a methodological study in which two groups participated: children aged 6 to 12 years and adolescents aged 13 to 19 years. The modified and unmodified MST method of the bag were used in random order. The tests were carried out in two days with an interval of 7 days. A team of two evaluators blinded to reading (1 and 2) and five readers participated, both trained and with adequate reliability. Examiner 2 participated in the second day of evaluation, randomly assigned. Three repetitions of the maximum isometric strength of seven lower limb muscle groups (hip flexion, extension and abduction, ankle and dorsiflexion, knee flexion and extension) were performed alternately on the dominant and non-dominant side. The contractions lasted 5 seconds and standardized verbal stimuli were offered. After normality tests, ANOVA and/or Kruskal-Wallis One-way analyses of variance were performed to compare the values of the different forms of operation. Intraclass correlation coefficient (ICC 2.1 and 3.1) was calculated to establish the values of testretest and inter-examiner reliability for muscle groups, dominant, non-dominant side and for different forms of measurement. 64 participants were included for analysis of operationalization and of these, 14 did not return on the second day of testing and were excluded from the reliability analyzes. Fifty participants were recruited in two groups for the reliability analysis: 26 children (8.65±1.83 years) and 24 adolescents (16.29±2.29 years). The analysis of variance (n=64) showed similar values between the different forms of operationalization of the measures for the two instruments (0.22≥F≤1.07; 0.34≥p≤0.85 / 0.71≥X2≤3.35; 0.34≥p≤0.81). The modified and unmodified MST showed moderate to very high reliability values between groups and with total participants (n=50) for test-retest and inter-examiner reliability (0.52≥ICC≤0.98) on the dominant and non-dominant side in all the different forms of operationalization. There was no difference between the forms of operationalization of the measures, being one measure sufficient to offer a reliable value. As for testretest and inter-examiner reliability, the values showed moderate to very high reliability for all forms of operationalization of muscle strength assessment in children and adolescents aged between six and 19 years. Thus, instruments can be used reliably for a measurement, facilitating the assessment of muscle strength of the lower limbs of children and adolescents in clinical practice.