Why is measuring hand grip important

Motor function of the paretic UL was assessed by using the Fugl-Meyer Motor Assessment Scale UL section , with adequate validity and reliability in subjects with stroke 25 The section related to UL motor function consists of 33 items, and the score for each item was added to the total score.

The global strength of the paretic UL wrist, elbow and shoulder flexors and extensors, and shoulder abductors was evaluated by using both the microFET2 TM digital handgrip dynamometer Hoggan Health Industries Inc. The sphygmomanometer was adapted for the bag method. The inflatable part of the whole external Velcro that constitutes the cuff of the equipment was removed, and this structure was folded into three equal parts and placed in an inelastic cotton bag with a zipper, as described previously 19 The portable dynamometers and sphygmomanometers, purchased factory-calibrated for the completion of this study, were used as per the manufacturers' instructions.

After the adaptation of the sphygmomanometer to the bag method and before using it for data collection, the recommended calibration procedures were performed 19 All of the tests were performed in a single day by a previously trained, single examiner. First, clinical and demographic data were collected, such as age, sex, body weight, height, post-stroke time, and type of stroke. The Fugl-Meyer Scale was applied before the muscle strength tests. Muscle strength was assessed by a single examiner, while the reading and recording of the measures were performed by another examiner.

No communication was allowed between the examiners regarding the measurements obtained. Before the evaluation of muscle strength, the allocation of the equipment portable dynamometer and modified sphygmomanometer was performed by means of a random draw. A rest period of 2 minutes was allowed between the evaluations with the devices 26 Assessment of the strength of the trunk and upper limb muscles in stroke subjects with portable dynamometry: a literature review.

The measurements of global UL strength wrist, elbow and shoulder flexors and extensors, and shoulder abductors 3 3. Hand-grip dynamometry provides a valid indication of upper extremity strength impairment in home care patients. Adequacy of simple measures for characterizing impairment in upper limb strength following stroke. However, some participants were not assessed for all muscle groups because of difficulty generating the maximal isometric strength. Thus, the number of measurements for global strength of the paretic UL, considering all the muscle groups selected, was lower than the number of measurements obtained for grip strength and motor function.

The positions during the measurements, stabilization to prevent compensatory movements, and verbal stimulation were standardized and adopted in the measurements using the two devices. For the assessment of strength of the paretic UL by using a hand-held dynamometer and the MST, the subjects remained in the supine position, following the protocol described by Bohannon 29 Test-retest reliability of hand-held dynamometry during a single session of strength assessment. Relationships and responsiveness of six upper extremity function tests during the first six months of recovery after stroke.

J Neurol Phys Ther. Figure 1. Assessment of handgrip strength with the Modified Sphygmomanometer Test. Immediately before the measurement of muscle strength, the procedures were performed for demonstration and familiarization.

During the tests, the subjects were instructed to perform a maximum isometric contraction for 5 s, and the peak force was recorded. The volunteers received verbal stimulus to start the movement and maintain contraction as follows: "Ready, set, GO!

That's it! Comparison of three hand dynamometers in relation to the accuracy and precision of the measurements. Rev Bras Fisioter. Only one trial was performed after the familiarization because, according to a previous study 32 Dynamometry for the assessment of grip, pinch, and trunk strength in subjects with chronic stroke: reliability and various sources of outcome values.

Int J Phys Med Rehabil. If the examiner recognized some compensatory movement by the participant, a new measurement was obtained and registered 21 The force exerted on the modified sphygmomanometer was determined by pressure gauge reading, considering increments of 2 mmHg. Before each measurement, the examiner ensured that the equipment was pre-inflated at 20 mmHg 33 The interrater reliability of force measurements using a modified sphygmomanometer in elderly subjects.

Descriptive statistics and normality tests Shapiro-Wilk were performed. Normally distributed data were observed for all continuous variables. The global strength of the paretic UL was calculated sum of the muscle strength values of the flexors and extensors of the wrist, elbow and shoulder, and shoulder abductors for the portable dynamometer and MST measurements. The Pearson correlation coefficient was calculated to determine whether the grip strength values obtained by using the portable dynamometer and those obtained by using the MST correlated with the global strength of the paretic UL, which was also measured by using the two devices.

The Spearman correlation coefficient was used to investigate the correlation between the grip strength values and the motor function of the paretic UL. When the coefficient values were statistically significant, the magnitudes of the correlations were classified as follows 34 Munro BH.

In: Munro BH, editor. Statistical methods for health care research. To investigate the predictive relationship between grip strength and the global strength and motor function of the paretic UL, four models of stepwise multiple regression were analyzed, two for the subjects with stroke in the subacute phase and two for the subjects with stroke in the chronic phase.

For each of the samples, the dependent variable was the grip strength of the paretic hand, evaluated by using a dynamometer, in one model and muscle strength, assessed by using the MST, in another model. It is worth noting that, for the model where the dependent variable was grip strength evaluated by using the MST, the global strength of the paretic UL, also measured by using the MST, was considered as a predictive variable, maintaining similarities with the portable dynamometer measurements.

The clinical and demographic characteristics of these subjects are described in Table 1. Table 2 presents the results of the descriptive statistics of the measurements of muscle strength and motor function of the paretic UL for the subacute and chronic groups. As shown in Table 3 , grip strength showed significant moderate to high correlations with the measurements of motor function and global strength of the paretic UL, both for the MST values 0.

As can be seen in Table 4 , both for the subjects in the subacute and chronic phases of the stroke, the regression model for the measurements obtained with the MST presented similar results to those for measurements obtained with a handgrip dynamometer. Among the four predictive variables considered for each of the four models, only one was retained in all of them.

The global strength of the paretic UL had significant predictive values ranging from 0. The present study demonstrated that the grip strength values obtained with the MST presented a significant positive correlation and similar magnitude moderate to high with those obtained by using a handgrip dynamometer for both global strength and motor function of the paretic UL in the subjects in the subacute and chronic phases of the stroke.

In addition, the predictive model of grip strength measured with the MST was similar to that measured with a handgrip dynamometer both for subjects in the subacute and chronic phases. Among the four variables considered as possible predictors sex, age, UL motor function, and global UL strength , only global UL strength presented a significant predictive value for grip strength. The similarity of the statistical results, considering the measurements obtained with the MST and a handgrip dynamometer, reinforce the positive results that have been pointed out for the validity of the MST 20 Therefore, in addition to the appropriate test-retest and interrater reliability and adequacy of the concurrent validity for the assessment of muscle strength of subjects with stroke 20 There were conflicting reports about the association between vertebral fracture and HGS.

Samelson et al. They found that HGS did not associate with the risk of vertebral fracture. However, Cawthon et al. Also, it was revealed that low HGS was associated with an increased clinical vertebral fracture risk over a year period in the study based on 1, Japanese postmenopausal women with a hazard ratio of 4. Numerous studies have been published about HGS. For proper interpretation of these studies, it is imperative to understand that there can be variations in HGS by the use of different type of dynamometers, body and arm positions, and anthropometric parameters.

HGS is one of the criteria for diagnosis of sarcopenia and the reference value can change according to the guidelines targeting relevant study populations.

Additionally, most studies have reported relatively low HGS in hip fracture patients, but the relationship between HGS and vertebral fractures is not definite. Future studies with accurate measurement and interpretation of HGS may reveal more beneficial information on sarcopenia and related areas. Thanks for the photographs of dynamometers to Fabrication Enterprises Inc. Ethics approval and consent to participate: Not applicable.

Conflict of interest: No potential conflict of interest relevant to this article was reported. National Center for Biotechnology Information , U. Journal List J Bone Metab v. J Bone Metab. Published online May Find articles by Seung Hoo Lee. Find articles by Hyun Sik Gong. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Corresponding author: Hyun Sik Gong. This article has been cited by other articles in PMC.

Abstract Handgrip strength HGS is associated with several chronic diseases, cognitive decline, length of hospital-stay, and mortality. Hydraulic type Jamar and its variants The Jamar and its variants, which are currently most widely used, measure HGS through a sealed hydraulic system Fig. Open in a separate window. A Hydraulic type dynamometer Jamar. It consists of two handles and one handle is curved to fit the hand.

B Jamar displays grip force in pounds and kg up to pounds or 90 kg. The needle records automatically the highest force exerted to provide an easy and exact reading. Pneumatic type Modified sphygmomanometer and Martin Vigorimeter The pneumatic types use the compressive force to an air-filled bulb or bag Fig. Pneumatic type dynamometer Martin Vigorimeter. Three sizes of balloons are available for pediatric and adults. Mechanical type dynamometer Smedley type.

A Baseline. Body position: standing, sitting, and lying down Teraoka [ 36 ] reported that HGS was weaker when lying down than standing or sitting, and he suggested the influence of gravity as one of its causes. Arm position There is no consensus on the effect of the arm position to HGS. Table 1 Cut-off value for low handgrip strength. Table 3 Normative data of hand grip strength in Koreans. Footnotes Ethics approval and consent to participate: Not applicable.

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