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J Electromyogr Kinesiol. 2013 Dec;23(6):1283-8. doi: 10.1016/j.jelekin.2013.09.004. Epub 2013 Sep 23.

Validity and reliability of isometric, isokinetic and isoinertial modalities for the assessment of quadriceps muscle strength in patients with total knee arthroplasty.

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  • 1Neuromuscular Research Laboratory, Schulthess Clinic, Zurich, Switzerland; Institute of Human Movement Sciences and Sport, ETH, Zurich, Switzerland; Laboratory of Human Motricity, Education, Sport and Health (LAMHESS) - EA 6309, University of Nice Sophia Antipolis, Nice, France.


Reliability of isometric, isokinetic and isoinertial modalities for quadriceps strength evaluation, and the relation between quadriceps strength and physical function was investigated in 29 total knee arthroplasty (TKA) patients, with an average age of 63 years. Isometric maximal voluntary contraction torque, isokinetic peak torque, and isoinertial one-repetition maximum load of the involved and uninvolved quadriceps were evaluated as well as objective (walking parameters) and subjective physical function (WOMAC). Reliability was good and comparable for the isometric, isokinetic, and isoinertial strength outcomes on both sides (intraclass correlation coefficient range: 0.947-0.966; standard error of measurement range: 5.1-9.3%). Involved quadriceps strength was significantly correlated to walking speed (r range: 0.641-0.710), step length (r range: 0.685-0.820) and WOMAC function (r range: 0.575-0.663), independent from the modality (P < 0.05). Uninvolved quadriceps strength was also significantly correlated to walking speed (r range: 0.413-0.539), step length (r range: 0.514-0.608) and WOMAC function (r range: 0.374-0.554) (P < 0.05), except for WOMAC function/isokinetic peak torque (P > 0.05). In conclusion, isometric, isokinetic, and isoinertial modalities ensure valid and reliable assessment of quadriceps muscle strength in TKA patients.

Copyright © 2013 Elsevier Ltd. All rights reserved.


Arthroplasty; Muscle strength; Reproducibility of results; Self report

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