Isometric strength quadriceps muscle
Isometric quadriceps strength will be measured against a
strap and HHD with the patient sitting and the knee at
90° flexion [59]. Isometric quadriceps strength has been
tested at knee flexion angles of 45-90° [60] and is recommended
to be tested at 60-90° knee flexion [61].
Isometric quadriceps strength measured with HHD at
90° knee flexion has demonstrated excellent reliability
(ICC (2,1) = 0.96) and MDC95 of 0.58 N/kg following TKA
[59]. If the participant cannot flex their knee to 90°, isometric
quadriceps strength will be measured at the
maximum range of flexion available and the range will
be recorded. The hand-held dynamometer (HHD) will
be placed on the anterior aspect of the distal tibia,
5 cm proximal to medial malleolus. Stabilization of the
HHD will be achieved by wrapping a seatbelt around
the HHD and securing it to a fixed attachment of the
plinth. The participants will perform a maximal voluntary
isometric contraction (MVC) by extending their lower leg
against the dynamometer and seatbelt, held for 5 seconds.The highest of three consecutive measures will be recorded
as the MVC.