Analyses of Isokinetic Thigh Muscle Strength: Camera-Based Assessment Alters the Magnitude, but Not the Message

Background: Thigh muscle strength capacities are major modifiable risk factors for knee and thigh muscle injuries. Therefore, their valid assessment is essential. Most isokinetic knee tests are conducted in a seated position and rely on dynamometer-based data. However, their accuracy is doubtful because axis alignment is erroneous. Purpose: This study investigated if hip angle (flexed vs. extended) and assessment method (dynamometer-based vs. camera-based) affect isokinetic outcome parameters. Methods: Sixteen healthy male participants (27 years, 184 cm, 80 kg) performed discrete isokinetic tests of the knee flexors and extensors (60 degrees/s) while their kinematics were captured (100 fps). Results: Both assessment methods revealed very strong linear relationships (94% <= R-2 <= 98%) although peak moments (d <= 0.87), contractional work (d <= 1.26), and functional knee flexor:extensor ratios (d <= 0.81) significantly differed. Seated knee flexor tests demonstrated the largest knee trajectory center's misalignment (x = 4.0 cm, z = -2.5 cm; 1.37 <= d <= 4.74). Conclusion: Hip-angle induced kinematic changes did not affect the relation between the lever arms, thus causing highly proportional deviations of kinetic parameters. The assessment method altered the magnitude, but not the message of isokinetic knee tests, which should be preferentially performed with extended hip joint to improve axis alignment. Knowledge of these kinetic and kinematic interactions assists practitioners and scientists with isokinetic tests and/or rehabilitation training to ensure reasonable interpretations of gathered isokinetic outcomes.