Strength Isometric Test: Knee Flexion

There are two ways to perform this test. Let’s start with option 1 - the handheld option:

1. Have the client adopt a prone position on a massage table.
2. To maximize leverage, ensure the Muscle Meter is held close to the practitioner’s body while performing this test. 
3. Place the press pad of the Muscle Meter just above the posterior aspect of the client’s achilles tendon. 
4. While the client is in roughly 10-20 degrees of knee flexion, have them press as hard as they can, holding for 2-3 seconds to achieve peak force production.
5. Simply hit save in the Measurz app and compare to the opposite side.

Option 2 is perhaps the most reliable, using the ankle and leg strap included in your Muscle Meter package:

1. As long as the massage table has a solid stable structure underneath, anchor the leg and ankle strap to one of the supporting structures of the table. 
2. Take the slack of the strap and thread the foot of the testing side through until the strap is resting around the client’s achilles tendon.
3. Have the client slide up the table in a prone position until everything is comfortable.
4. Once set, queue the client to flex their knee up as best they can, holding for 2-3 seconds to achieve maximal force production. 
5. Once performed, hit save on the Measurz app and compare to the other side.

It's important to note that proper training and experience with muscle meter are necessary to obtain accurate and reliable results.

Normative data for isometric knee flexion strength with a muscle meter varies depending on the population being tested and the specific dynamometer used. However, here are some general normative values for knee flexion strength in adults:

• For males, the normative value for isometric knee flexion strength is around 120-140 Nm (Newton meters).
• For females, the normative value for isometric knee flexion strength is around 70-90 Nm (Newton meters).

Again, it's important to note that these values are general and may vary based on age, gender, body weight, and other factors. Additionally, it's important to use normative values that are specific to the dynamometer being used to ensure accuracy and reliability of the results.

References:

1. Bohannon RW. Reference values for extremity muscle strength obtained by hand-held dynamometry from adults aged 20 to 79 years. Arch Phys Med Rehabil. 1997;78(3):26-32.
2. Macfarlane DJ, Chou KL, Cheng YH, Chi I. Validity and normative data for thirty-second chair stand test in elderly community-dwelling Hong Kong Chinese. Am J Hum Biol. 2006;18(3):418-421.
3. Visnapuu M, Jürimäe T. Hand-held dynamometry in measuring muscle strength: a meta-analysis. Physiother Res Int. 2002;7(1):1-16.
4. Kelln BM, McKeon PO, Gontkof LM, Hertel J. Hand-held dynamometry: reliability of lower extremity muscle testing in healthy, physically active, young adults. J Sport Rehabil. 2008;17(2):160-170.