The Clinical Reference You've Been Waiting For

By: Frank Aerts and Becky Alwood

Research and clinical practicality merge in a systematic and approachable method. This book is the authoritative guide to the application of dynamometry in clinical practice.

Providing clinicians with everything they’ll need to practice dynamometry, Hand-Held Dynamometry: Guidelines for Daily Clinical Practice is the fundamental resource for any clinician applying evidence-based practices.

Broken into five detailed sections, this guide opens with a foundation of the science and research supporting the use of hand-held dynamometry as best practice in the modern clinical setting. That layout undergirds the “movement, muscle, exercise’ delineation that helps clinicians apply research in a systematic way.

Experienced clinicians and new practitioners alike will benefit from this streamlined, reliable, and valid system for objective strength measurement.

Movement
Muscle
Exercise

What is MET?

MET’s MET-odology is the contemporary development of Medical Exercise Therapy clinical concepts introduced by physical therapist Oddvar Holten. Medical Exercise Therapy has proven its value over time by providing effective and efficient clinical outcomes through precision design, dosing, and delivery of therapeutic exercise.

Guided by principles of value, clinical best practice, and the biopsychosocial model, our MET-odology serves as a framework to the operational and clinical aspects of rehabilitation services.  It educates and empowers rehabilitation professionals to deliver precision therapeutic exercises and interventions in a value based healthcare system, ultimately bringing measurable and meaningful clinical outcomes to the client.

The clinical therapeutic fields have long battled against one large challenge– objective measurement. In the early stages of a therapeutic plan, the majority of the assessment is done with an inherent practitioner bias. It’s no fault of the therapists. Rather, practitioners have for decades lacked appropriate instrumentation and training to apply the benefits of modern technology to their science.

Those days are gone. The simplification, miniaturization, and affordability of dynamometers have brought the power of empirical measurement to the hands of well-trained clinicians the world over.

While hand-held dynamometers are not a new invention, their application in clinical settings has been inconsistent.  While a plethora of research exists demonstrating dynamometry’s efficacy, the testing positions are inconsistent, the props are cumbersome, and inefficiencies make it nearly impossible to transfer the research into daily clinical practice.

Hand-held Dynamometry: Guidelines for Daily Clinical Practice bridges the gap between research and clinical practice by serving as an approachable and comprehensive resource for clinicians to reference.

Overview & Technique

In the first section of the guide, the authors take the time to establish best practices, techniques, postures, and positions that will be referenced and used throughout the text. Readers will learn the standardized testing positions, accurate placement of tools, and best practices for ensuring reliable and valid measurements.

Standardized postures and positions for client and provider are outlined for all movement bias and muscle bias tests along with standardized instrument placement. Recommendations and examples are provided for measurements with exercise bias.

Movement Bias

The purpose of clinical dynamometry with movement bias is to quantify muscle force produced during cardinal movements. Instrument placement, client and provider postures and positions are chosen to assure that measurements are of highest reliability and able to be performed by most of the population and in all clinical settings.

Movement bias tests are recommended for all clients as part of a standard clinical examination and results should be documented in the medical chart.

Muscle Bias

The purpose of clinical dynamometry with muscle bias is for diagnostic purposes.  A muscle’s ability to generate force is assessed in a position of relative isolation from its synergists.

Muscle bias tests are performed with the client in upright postures when possible. Muscle bias tests can detect subtle weaknesses within the kinetic chain. Side to side comparisons are made and are part of a precise biomechanical clinical examination.

Exercise Bias

Dynamometry tests are performed to help determine the precise dose of a therapeutic exercise. The result of an isometric dynamometry test determines the initial test dose for a clinical fatigue test. The result of the clinical fatigue test will then determine the therapeutic exercise dose. Each dynamometric test is performed in the posture and position of the selected exercise.

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