News and Resources

Clinical Strength Assessment – April 2017

By: Dr. Marc Sherry PT, DPT, LAT, CSCS, PES

The NFL Combine, held prior to each year’s draft, evaluates participants in the bench press and vertical jump along with a variety of other tests.  The Army physical fitness test includes a number of push-ups and sit-ups in 2 minutes, pull ups and a two-mile run.Interestingly, these tests are not utilized because they are specific to the sport or to the military or even a direct indicator of performance.  For example, a defensive back’s repetitions on a bench press test do not measure how well he can cover a wide receiver on the football field.  Yet, these tests persist because they are objective, reproducible measurements of strength and fitness.  Thus, they can easily be used to compare differences between individuals and changes in individual performance over time.

Similarly, after injury or surgery, one’s ability to regain strength over time is one of the cornerstones to successful rehabilitation and return to work or sport.  In addition, measuring strength from limb to limb or a comparison of strength across a group of people can be an effective method of screening for potential injury.

Historically, the options for objective, reproducible and efficient methods to measure strength have been very limited.  The two primary methods of clinical strength assessment are manual muscle testing and isokinetic dynamometry.

Manual Muscle Testing

Unfortunately, manual muscle testing is not very sensitive or specific and varies significantly from individual to individual and clinician to clinician.

Isokinetic dynamometry, on the other hand, can provide very objective and reproducible measurement, but also has significant limitations.  The primary obstacles for its use include significant cost, lack of portability and the inability to adapt test positions or test movements that involve more than one joint.

Traditional Dynamometer Testing

These long-standing clinical frustrations are a thing of the past, thanks to the Kiio force sensor. The Kiio force sensor provides precise, objective assessment data with a footprint the size of a deck of cards, which provides excellent portability and adaptability.

A study by Dr. Grabowski recently published in Military Medicine found the Kiio sensor had excellent reliability, responsiveness and validity.  This study tested rotator cuff strength on 44 physically active adults using the Kiio force sensor and an isokinetic dynamometer. The study concluded both methods were valid, but Kiio wins on a variety of other factors including cost, portability and adaptability.

The portability, reliability, and validity of the Kiio sensor give it tremendous potential for injury prevention as well as injury rehabilitation.   Currently, the UW Health Sports Rehabilitation group and select professional and amateur baseball clubs are using Kiio’s force sensor for pre-season and in-season screening.  The goal is to identify changes in strength ratios or a drop in strength as a leading indicator to potential injury, so preventative measures can be taken.  UW Health also recently received a grant from theDepartment of Defense to study tendinopathy and the Kiio sensor will assess force, power and endurance as in an integral part of the study.

In addition to applications in clinical research and larger population assessments, the Kiio force sensor also provides value in daily patient care.  The portability and ease of use allows physical therapists and rehab professionals to quickly re-assess patient strength and objectively measure changes since their last session.  The availability of more precise data allows therapists to develop superior treatment programs, proactively implement changes, and apply appropriate progressions.  This, in turn, benefits the patient through quicker recovery and enhanced rehabilitation.

The cost-effective and clinically validated results of the Kiio force sensor make it an excellent choice for a variety of applications spanning clinical research, elite athletic training, and daily clinical use. Click here to review Kiio’s rehabilitation solutions and request more information or a demo.

Kiio CEO Dave Grandin to Speak at Tech Summit

Kiio CEO Dave Grandin will participate Monday in the Wisconsin Tech Summit opening session panel discussion. Other panel members include Sujeet Chand of Rockwell Automation and Vivek Bhatt from GE Healthcare. The fourth annual event is being held March 27th at the GE Healthcare Institute in Waukesha. Visit for the full agenda.

Other major firms participating include Aurora Health Care, BloodCenter of Wisconsin, Dedicated Computing, Direct Supply, Exact Sciences, GE Healthcare, HP Enterprise Services, Johnson Controls, Marshfield Clinic Information Services, Northwestern Mutual Future Ventures, Promega, Racine Metal-Fab, Rockwell Automation, TECHNIPLAS and UW-Madison Research Pathways.

Opioids and Low Back Pain – Changing the Paradigm

A Rising Epidemic

With more than 30 percent of Americans experiencing an episode every year, it’s no surprise that low back pain is a leading reason for physician visits.

Too often, that visit results in an opioid prescription, leading to low back pain sufferers making up more than half of regular prescription opioid users. According to National Medical Expenditure Panel Survey (MEPS), opioid prescriptions for back pain have increased dramatically over the last 20 years, without a correlated decrease in the amount of pain reported.

This is problematic for two reasons.

The American Society of Addiction Medicine lists drug overdose as the leading cause of accidental death in 2015 and the Centers for Disease Prevention and Control (CDC) reports that opioid prescriptions are a driving factor in the 15-year increase in opioid overdose deaths, with deaths attributed to prescription opioids quadrupling since 1999. The link to heroin and other opioid abuse is also well documented, with over three quarters of abusers reporting their first opioid was prescribed. Even for adherent users, common opioid side effects can be unconducive to good quality of life.

Second, opioids have been clinically proven to be inefficacious for treatment of low back pain. They may temporarily mask pain but they do not expedite return to work or improve functional outcomes in acute low back pain, nor have they been shown effective in long-term management of chronic low back pain.

Evidence-Based Treatment of Low Back Pain

Last month, the American College of Physicians (ACP) issued a clinical practice guideline recommending doctors avoid opioids in the treatment of nonradicular low back pain and instead prescribe exercise, rehabilitation or alternative therapies. This guideline was issued based on an extensive review of peer-reviewed research, including randomized control trials and data from observational studies.

All stakeholders, including providers, healthcare payers and patients, benefit from care that follows treatment pathways grounded in evidence-based best practice. Unfortunately, current treatment practices for low back pain vary widely, often resulting in increased costs and failure to meet outcome goals.

In addition to the ACP recommendations, a body of clinical research exists to provide guidance in the development of evidence-based care pathways. Innovations in care delivery models and technology play an important role as they facilitate practical implementation of evidence-based care and connect stakeholders. We will be talking more about specific research and care delivery innovations in upcoming posts.

A Team Approach

We all have a stake in designing and demanding care that leverages the best that both science and technology offer in delivering value. The shift to a team-based approach has begun, with more patients demanding tools that facilitate active participation in their healthcare as well as insurers and employers increasingly embracing a leadership role as collaborative partners in the wellness of their members and employees.

Using evidence-based care to improve low back pain will result in significantly reduced opioid prescription, reductions in other ineffectual and costly treatment and, most importantly, better results.

Lydia Zeller is Kiio’s Director of Patient Engagement. She can be reached at

Kiio Featured on

As a varsity swimmer at the University of Wisconsin, Dave Grandin knew the value of conditioning as he practiced to prepare for competitions.

And while swimming was his first sport love, a computer science degree, a MBA and electrical engineering credentials later has found the pioneer pooling his varied knowledge to apply technology to the challenge of measuring resistance training.

Read the full article titled, “Science & Technology – Resistance Training Gets Smart with Kiio,” on