Experimental Approach of Quadriceps Strength Measurement: Implications for Assessments in Critically Ill Survivors

Anne-Françoise Rousseau; Isabelle Kellens; Pierre Delanaye; Olivier Bruyère; Benoit Misset; Jean-Louis Croisier

doi:10.3390/diagnostics12010202

Experimental Approach of Quadriceps Strength Measurement: Implications for Assessments in Critically Ill Survivors

Diagnostics (Basel). 2022 Jan 14;12(1):202. doi: 10.3390/diagnostics12010202.

Authors

Anne-Françoise Rousseau¹, Isabelle Kellens¹, Pierre Delanaye^{2

3}, Olivier Bruyère⁴, Benoit Misset¹, Jean-Louis Croisier⁵

Affiliations

¹ Intensive Care Department and Burn Centre, University Hospital, University of Liège, 4000 Liège, Belgium.
² Department of Nephrology-Dialysis-Transplantation, University Hospital, University of Liège, 4000 Liège, Belgium.
³ Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, 30900 Nîmes, France.
⁴ Department of Public Health, Epidemiology and Health Economics, University of Liège, 4000 Liège, Belgium.
⁵ Department of Sport Sciences and Rehabilitation, University of Liège, 4000 Liège, Belgium.

Abstract

(1) Background: The supine testing position is suitable for early quadriceps strength (QS) assessment in intensive care unit, while a seated position is more appropriate for survivors who have regained mobility. Acquiring consistent measurements is essential for longitudinal follow-up. We compared the QS generated in different settings in healthy volunteers. (2) Methods: Isometric QS was assessed using a MicroFet2 and standardised protocols comparing different modalities. Hip and knee flexion angles were, respectively, 45° and 40° (H45-K40) in the supine position, and both at 90° (H90-K90) in the seated position. Dynamometer was either handheld (non-fixed configuration, NFC), or fixed (FC) in a cubicle. (3) Results: QS in H90-K90 and H45-K40 positions were strongly correlated, but QS was higher in the later position regardless of the configuration. Compared to H45-K40, biases of 108.2N (or 28.05%) and 110.3N (27.13%) were observed in H90-K90 position, respectively, in the NFC and FC. These biases were independently and positively associated with QS (p < 0.001). For both position, there were no significant differences between QS measured in NFC or FC. (4) Conclusions: The quadriceps was less efficient in the seated position, compared to the supine position, in healthy volunteers. These findings have practical implications for further assessments and research in critically ill patients.

Keywords: dynamometry; measurement bias; quadriceps strength; reliability; test conditions.