Reliability and Validity of the Ground Reaction Force Asymmetric Index at Seat-Off as a Measure of Lower Limb Functional Muscle Strength: A Preliminary Study

Featured Application The reliability of this newly developed test measuring lower extremity muscle strength using force plate during sit-to stand performance was measured as high, but the validity was poor. To be clinically useful, this test should be further refined by modifying the test protocol and method. This study examined the reliability of the newly developed ground reaction force asymmetry index (GRF AI) at seat-off using a low-cost force plate and the validity of this new test by comparing it with other muscle strength-measuring methods and walking speed. This study was a cross-sectional design in general hospital setting. A convenience sample of 47 community-dwelling adults aged >= 40 years was performed. GRF AI is the measurement value obtained by shifting the weight to the right and left while performing sit-to-stand (STS). GRF AI assessed using GRF data at seat-off during an STS test with maximal weight shift to the right and left side and repeated 4 weeks later. Hip and knee extensor strength were measured using hand-held dynamometry; hand grip strength and walking speed were measured using a standardized method. Intrasessional intrarater reliability of the right and left side at Sessions 1 and 2 were high (intraclass correlation coefficients [ICC] = 0.947 and 0.974; 0.931 and 0.970, respectively). In addition, the intersessional intrarater reliability of a single test trial (ICC = 0.911 and 0.930) and the mean of three test trials (ICC = 0.965 and 0.979) was also high. There was a low correlation between right-side GRF AI and right hand grip strength (r = 0.268) and between left-side GRF AI and left hand grip strength (r = 0.316). No significant correlations were found between the GRF AI and other parameters. Although the reliability of the GRF AI was high, the validity was poor. To be clinically useful, this test should be further refined by modifying the test protocol.

Automated summary

The newly developed test for measuring lower extremity muscle strength during sit-to-stand performance using a force plate showed high reliability but poor validity. Further refinement of the test protocol is needed for clinical usefulness.