Clinimetric Properties of the Applied Kinesiology Manual Muscle Test in Adults With and Without Pain: A Methodological Study

Décio G. Oliveira MS , Gabriel M. Oliveira BPT , Renata N. Kirkwood PhD
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Abstract

Objective

The purpose of this study was to determine the intra- and interexaminer reliability, concurrent validity, and responsiveness of the applied kinesiology manual muscle test (AK-MMT) to discriminate gluteus medius muscle strength and latency.

Methods

A cross-sectional and methodological study was conducted in 38 participants using electromyography, electrogoniometry, and hand-held dynamometry to measure latency, angular displacement, and muscle force during the assessment of the gluteus medius by AK-MMT. Inter- and intrarater reliability of 2 examiners with different levels of experience were obtained using the intraclass correlation coefficient. Muscle force, latency, and joint angular displacement were compared between groups (facilitated vs inhibited). Latency and angular displacement also were compared within groups by using the Wilcoxon paired test. For the concurrent validity of the AK-MMT in classifying an inhibited muscle as weak, the receiver operating characteristic curve was conducted.

Results

Intra- and interexaminer reliability for the facilitated vs inhibited classifications based on AK-MMT presented good results, with intraclass correlation coefficient > 0.86. For the inhibited group, force and peak force were significantly lower and joint displacement significantly greater. The receiver operating characteristic curve showed an area under the curve of 0.743, demonstrating that the test has concurrent validity (P = .001) to discriminate muscle force. The Wilcoxon paired test showed a significant delay in latency of the inhibited gluteus medius group (0.10 s vs 0.18 s, P = .007) when compared with the facilitated one.

Conclusion

In this study, we found good intra- and interexaminer reliability and concurrent validity for the AK-MMT to determine differences in gluteus medius muscle force. Although the paired data showed a different latency time between groups, the hypothesis of prolonged latency in muscles classified as inhibited by AK-MMT still needs further investigation.

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应用运动学手工肌肉测试在有和没有疼痛的成年人中的临床特性:一项方法学研究
目的本研究的目的是确定应用运动学手工肌肉测试(AK-MMT)鉴别臀中肌力量和潜伏期的内部和内部的信度、并发效度和反应性。方法对38名参与者进行横断面和方法学研究,采用肌电图、角电测量和手持式测力仪测量AK-MMT评估臀中肌时的潜伏期、角位移和肌肉力。采用类内相关系数对两名不同经验水平的审查员的内部信度和内部信度进行分析。肌肉力量、潜伏期和关节角位移在两组之间进行比较(促进组与抑制组)。潜伏期和角位移也通过Wilcoxon配对检验在组内进行比较。为了验证AK-MMT对被抑制肌肉分类为弱肌的同时有效性,我们绘制了受试者工作特征曲线。结果基于AK-MMT的促进与抑制分类的内、间信度均较好,类内相关系数为>0.86. 抑制组的力和峰值力显著降低,关节位移显著增大。受试者工作特征曲线下面积为0.743,说明该测试对肌力鉴别具有并发效度(P = 0.001)。Wilcoxon配对检验显示,与促进组相比,抑制臀中肌组的潜伏期明显延迟(0.10 s vs 0.18 s, P = .007)。结论在本研究中,我们发现AK-MMT在测定臀中肌肌力差异时具有良好的内部和内部信度和并发效度。虽然配对数据显示各组之间的潜伏期不同,但AK-MMT抑制肌肉潜伏期延长的假设仍需进一步研究。
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