Pre-test checklist

A condensed printable companion to the full isometric knee extension protocol. One page, scannable, what to do before the patient sits down, while you're setting up, in the cueing minute, during the trial, and between trials. Print it, post it next to the testing station, and use it as a reference rather than a memory aid.

Updated September 29, 2026

This is the short version of setting up a reliable isometric knee extension assessment and preparing the patient for their first MVIC. Print or post it next to the testing station; use the longer articles for the why behind each item.

The protocol below targets isometric knee extension: peak torque at 60° of flexion and, on a tension-gauge or hand-held device, RTD at 90°, where the limb's weight stops loading the baseline. Running an MVIC, and choosing the knee angle for your device explains the split. Adapt knee-angle and seat-position items for other joints; cueing and trial protocol items apply across joints.

Before the patient sits down

  • Plinth or chair set to your usual default height
  • Back support in place (padded backrest or folded towel against the wall)
  • Strap connected to dynamometer with carabiner or rigid tether
  • Tether anchored at a point in line with the shin
  • Dynamometer powered on and paired in the platform
  • Patient's height, bodyweight, and injured side entered on the patient profile (so torque, mass normalization, and LSI compute correctly)
  • Goniometer accessible

Patient positioning

  • Hips at 85 to 90° flexion
  • Popliteal crease clear of the seat edge (about 2 cm)
  • Waist strap across the pelvis, or patient gripping the plinth firmly
  • Chest strap if patient has poor trunk control
  • Ankle strap (10 to 12 cm wide, padded) just proximal to the medial malleolus
  • For the 60° peak test, initial knee angle set to about 70° (the knee extends roughly 10° at peak)
  • For the 90° RTD test, starting angle chosen on the practice trial so the knee lands at 90° at peak
  • Tether perpendicular (90°) to the shin at peak position
  • Moment arm measured if you're using direct measurement (lateral femoral epicondyle to ankle-strap center, in meters)

Familiarization

  • Explain the test in plain language: "isometric, doesn't move, three trials, five seconds each, thirty seconds rest"
  • Confirm the patient understands that the strap is fixed and won't break away
  • Run three practice trials at 50%, 75%, 100% effort
  • Confirm at 100% practice that the knee is at the test angle at peak and the tether is perpendicular; adjust if not, re-do practice
  • First recorded trial after this; familiarization is not on the patient's record

Each recorded trial

  • Patient settled, baseline quiet for two to three seconds
  • Pretension: lightest push that keeps the strap taut, then hold still; trace steady at about 5 to 15 N, not tared to zero
  • Effort cue: "Push as hard and as fast as you can, hold for five seconds"
  • Standardized verbal encouragement during the hold ("Push, push, push")
  • Watch the chart for: sharp onset, smooth ramp, sustained plateau, controlled release
  • Five seconds; if the curve is still rising at the five-second mark, rest five minutes and re-cue with clearer "fast" emphasis

Between trials

  • 30 seconds rest before the next maximal-effort trial
  • Quick visual check of the chart for: countermovement dip at onset, drift through the plateau, post-release rebound that doesn't return to baseline
  • If baseline is visibly drifting between trials, retare the dynamometer
  • Countermovement or hesitant start: exclude it on the session and move on
  • Plateau drift: exclude it, unless you only need RTD from this trial; then keep it and say so in the session notes

After the set

  • Three clean trials per side recorded
  • Excluded trials marked with a note about why (so the next clinician knows)
  • Onset overrides applied where the rise is clean but the auto-detected marker is off (not on countermovement trials, which are excluded)
  • Bilateral assessment: same protocol on the uninvolved side
  • Session ended (the platform saves the session on end, not during recording)

Try it in the Dynamometry Lab: an interactive version of this checklist, for a tension strap or a hand-held device.

What to do next

  • Print this page and keep it at the testing station. It's faster to glance at than to remember.
  • For the rationale behind each item, read the full protocol article and the patient-prep article. This page is a memory aid, not a substitute for understanding.
  • For data-quality decisions made during or after the test (exclude vs delete, onset override, drift warnings), see the Data Quality section.
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