{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T22:35:37Z","timestamp":1790030137854,"version":"4.0.1"},"reference-count":56,"publisher":"Journal of Orthopaedic & Sports Physical Therapy (JOSPT)","issue":"2","content-domain":{"domain":["www.jospt.org"],"crossmark-restriction":true},"short-container-title":["Journal of Orthopaedic &amp; Sports Physical Therapy"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec><jats:title>Study Design<\/jats:title><jats:p> Clinical measurement, cross-sectional. <\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p> Quadriceps deficits are common in individuals with knee joint impairments and impact functional and quality-of-life outcomes. Quadriceps strength symmetry influences clinical decisions after knee injury. Isometric electromechanical dynamometry (ISO-ED) is the gold standard for measuring symmetry, but is not available in all clinical settings. <\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p> To compare concurrent validity of handheld dynamometry and 1-repetition-maximum leg press, knee extension from 90\u00b0 to 0\u00b0, and knee extension from 90\u00b0 to 45\u00b0 to that of ISO-ED in identifying meaningful quadriceps strength deficits. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Fifty-six participants with knee joint impairments completed ISO-ED and 4 alternative measures of quadriceps strength symmetry in a single session. Absolute agreement of alternative measures with ISO-ED was calculated with intraclass correlation coefficients (ICCs). Clinical agreement values at thresholds of 80% and 90% symmetry were compared between the alternatives and ISO-ED. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Knee extension from 90\u00b0 to 45\u00b0 (ICC = 0.67) and handheld dynamometry (ICC = 0.70) had the greatest ICCs. Clinical agreement was also best for these measures for 80% symmetry (\u03ba = 0.56 and 0.55, respectively) and 90% symmetry (\u03ba = 0.19 and 0.33, respectively). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Handheld dynamometry and 1-repetition-maximum testing of knee extension from 90\u00b0 to 45\u00b0 are fair alternatives, although symmetry is typically overestimated. Receiver operating characteristic analysis identified alternative measure thresholds that correlated with the 80% and 90% symmetry thresholds on the ISO-ED. Clinicians should use more stringent symmetry values for these alternative tests to increase the probability that individuals have a minimum ISO-ED symmetry of 80% or 90%. J Orthop Sports Phys Ther 2017;47(2):97\u2013107. doi:10.2519\/jospt.2017.6651 <\/jats:p><\/jats:sec>","DOI":"10.2519\/jospt.2017.6651","type":"journal-article","created":{"date-parts":[[2017,2,1]],"date-time":"2017-02-01T07:51:52Z","timestamp":1485935512000},"page":"97-107","update-policy":"https:\/\/doi.org\/10.2519\/jospt.crossmarkpolicy","source":"Crossref","is-referenced-by-count":53,"title":["Diagnostic Accuracy of Handheld Dynamometry and 1-Repetition-Maximum Tests for Identifying Meaningful Quadriceps Strength Asymmetries"],"prefix":"10.2519","volume":"47","author":[{"given":"J. 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