{
  "abstract": "Objective\n\nThis systematic review and meta-analysis evaluated the measurement properties of handheld dynamometry (HHD) for assessing isometric ankle muscle strength in healthy individuals.Methods\n\nA comprehensive search was conducted in PubMed, EMBASE, CINAHL, Web of Science, SPORTDiscus, PsycINFO, Scopus, and the Virtual Health Library, with no language or date restrictions. Observational and methodological studies assessing dorsiflexors, plantar flexors, invertors, or evertors using HHD were eligible if they reported reliability, measurement error, or construct validity against isokinetic dynamometry. Random-effects meta-analyses were performed by measurement property and testing configuration, following COSMIN guidance.Results\n\nTwenty-four studies were included. Inter-rater reliability was good for dorsiflexors (ICC = 0.89, 95% CI 0.80-0.94), plantar flexors (ICC = 0.86, 95% CI 0.72-0.93), invertors (ICC = 0.79, 95% CI 0.66-0.87), and evertors (ICC = 0.75, 95% CI 0.46-0.90). Intra-rater reliability ranged from good to excellent (ICC = 0.88-0.91). External fixation was associated with numerically higher inter-rater ICCs for dorsiflexors and plantar flexors although subgroup differences were not statistically significant. Construct validity was strong for dorsiflexors (r = 0.87, 95% CI 0.42-0.98) but uncertain for plantar flexors (r = 0.72, 95% CI -0.20-0.96). Measurement error remained indeterminate due to the absence of an established minimal important change. Certainty of evidence was high for reliability and low for construct validity; measurement error was not graded.Conclusion\n\nHHD provides reliable assessment of isometric ankle strength, including without external fixation. Evidence for construct validity, particularly for plantar flexors, and for measurement error remains limited.",
  "abstract_shown": true,
  "affiliations": [
    "Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.",
    "Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil.",
    "Universidade Paulista (UNIP), São Paulo, SP, Brazil.",
    "Departamento de Pós-Graduação em Saúde Baseada em Evidências, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.",
    "Faculdade de Sete Lagoas (FACSETE), Sete Lagoas, MG, Brazil.",
    "Faculdade Ciências Médicas de Minas Gerais (FCM-MG), Belo Horizonte, MG, Brazil."
  ],
  "article_type": "systematic review",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Matheus Hissa Lourenço Ferreira",
      "orcid": "0009-0004-0371-1876"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "João Victor Völker Oliveira",
      "orcid": "0009-0006-1581-720X"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Nelson Carvas Junior",
      "orcid": "0000-0003-2168-8927"
    },
    {
      "affs": [
        1
      ],
      "name": "Túlio Medina Dutra de Oliveira",
      "orcid": "0000-0003-1160-2456"
    },
    {
      "affs": [
        4
      ],
      "name": "Guilherme Augusto Santos Araujo",
      "orcid": "0000-0003-4907-6017"
    },
    {
      "affs": [
        1
      ],
      "name": "José Elias Filho",
      "orcid": "0000-0002-4251-0290"
    },
    {
      "affs": [
        5
      ],
      "name": "George Schayer Sabino",
      "orcid": "0000-0002-6724-9295"
    },
    {
      "affs": [
        1
      ],
      "name": "Carla Malaguti",
      "orcid": "0000-0002-6619-136X"
    },
    {
      "affs": [
        1
      ],
      "name": "Diogo Carvalho Felício",
      "orcid": "0000-0001-5138-1884"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9chfhctep3pky.bib",
  "cited_by": 0,
  "doi": "10.1002/msc.70285",
  "fulltext_url": "https://europepmc.org/articles/PMC13695021",
  "id": "9chfhctep3pky",
  "issns": [
    "1478-2189",
    "1557-0681"
  ],
  "landing_url": "https://europepmc.org/article/MED/42920374",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2732|Foot and Ankle Surgery"
    ]
  ],
  "openalex": "W7223461817",
  "pdf_url": "https://europepmc.org/articles/PMC13695021?pdf=render",
  "pmcid": "PMC13695021",
  "pmid": "42920374",
  "published": "2026-10-30",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/9chfhctep3pky.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:32Z",
      "native_id": "MED:42920374",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42920374"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2732|Foot and Ankle Surgery",
      "subfield": "surgery"
    }
  ],
  "title": "Measurement Properties of Hand-Held Dynamometry for Ankle Strength Assessment: A COSMIN-Based Systematic Review and Meta-Analysis.",
  "title_text": "Measurement Properties of Hand-Held Dynamometry for Ankle Strength Assessment: A COSMIN-Based Systematic Review and Meta-Analysis.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:32Z",
  "url": "https://research.draconitic.com/paper/9chfhctep3pky",
  "venue": "Musculoskeletal care",
  "versions": []
}