Introduction There is a lack of consensus on the most relevant and clinically applicable tests to evaluate knee muscle strength following a knee injury. This systematic review aimed to critically appraise and summarize the measurement properties of knee muscle strength tests in young individuals with anterior cruciate ligament (ACL) or meniscus injury.
Materials and Methods Studies evaluating at least one measurement property of a knee extensor or flexor strength test in individuals with an ACL or meniscus injury with a mean injury age of ≤30 years were included. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist was used to assess methodological quality. A modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessed evidence quality.
Results Thirty-four studies evaluating 30 muscle strength tests following an ACL or meniscal injury were included. Strength tests were assessed for reliability (n=8), measurement error (n=7), construct validity (n=25) and criterion validity (n=7). Concentric extensor and flexor strength tests showed sufficient ratings for two measurement properties, namely for intra-rater reliability (very low quality of evidence) and construct validity (moderate quality of evidence). Isotonic extensor and flexor strength tests displayed sufficient criterion validity (high quality of evidence).
Conclusion This review highlights an important lack of evidence on measurement properties of strength tests following ACL tear and meniscus injury. Concentric strength tests are currently the most promising tests following an ACL injury. High-quality studies on measurement properties are needed to recommend muscle strength tests in research and clinical practice.
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