Comparison Between Handgrip Dynamometry and Manual Muscle Testing Performed by Registered Dietitians in Measuring Muscle Strength and Function of Hospitalized Patients

Dowhan, Lindsay; DeChicco, Robert; Welsh, Renee; Wehner, Rebecca; Habib, Monica; Hipskind, Peggy; Cresci, Gail

doi:10.1177/0148607115580647

Cited by 8 publications

(8 citation statements)

References 12 publications

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“…However, this method is time-consuming, costly, and requires a lot of experience for a proper interpretation of the results. In comparison, the current study reveals that HGS-measurement is an easy applicable test that can be incorporated into the physical examination in order to help objectively assess the current state of muscular fitness (15).…”

Section: Discussionmentioning

confidence: 82%

“…This is of outstanding importance, as the clinical impression of the treating physician can be misleading, especially if he is not experienced in the evaluation of the particular disorder. Furthermore, a decline in the functional status, defined as the ability to perform daily live activities, is challenging to assess in patients with CHD because the definition is vague and measurement is difficult (15). Moreover, several studies have suggested that the severity of the CHD and the illness course are only marginally associated with patient's health perception, the supposed condition and the quality of life (31).…”

Section: Discussionmentioning

confidence: 99%

“…HGS was measured according to a standardized protocol using a Jamar Hydraulic Hand Dynamometer (Jamar Hydraulic Hand Dynamometer Model 5030J1; Sammons Preston, Bolingbrook, IL, USA) (14). As recommended by the American Society of Hand Therapists, patients were instructed to sit in an upright position with shoulders adducted, elbow-flexed at 90°and forearms in neutral position (8,15). All participants were encouraged to give their best effort in isometric grip strength, with one repetition for each hand.…”

Section: Methodsmentioning

confidence: 99%

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The value of hand grip strength (HGS) as a diagnostic and prognostic biomarker in congenital heart disease

Neidenbach¹,

Oberhoffer²,

Pieper³

et al. 2019

Cardiovasc. Diagn. Ther.

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Background: In patients with congenital heart disease (CHD), there is little data on the diagnostic and prognostic relevance of hand grip strength (HGS) for clinical assignment, while in the general population the loss of muscle strength and mass is an important risk factor in cardiovascular disease which is conversely associated with morbidity and all-cause mortality. This study aimed to assess the degree of muscle dysfunction using HGS as a biomarker in a large group of patients with CHD who often develop muscle dysfunction.Methods: In total, 385 patients (27.6±13.1 years, 43% female) were included and assigned to 5 diagnostic groups: complex anomalies (n=131), left heart anomalies/aortopathies (n=107), right heart/pulmonary artery anomalies (n=92), primary left to-right-shunts (n=42) and miscellaneous CHD (n=13). Patients with Fontan circulation, chronic cyanosis, morphologic right systemic ventricle, arterial switch operation, or Ebstein's anomaly were analyzed separately. A control group (CG) consisted of 124 healthy individuals (30.1±12.1 years, 42% female). HGS was measured with a Jamar Hydraulic Hand Dynamometer.Results: HGS was reduced in CHD patients compared to controls (35.2±14.6 versus 43.7±14.4 kg). Most impairments were present in females (26.1±7.6 kg). Patients with cyanosis had lower HGS values compared to acyanotic CHD patients (P=0.03). Patients with left heart lesions had the highest HSG values (40.7±14.7 kg), while patients with primary left-to-right shunt lesions had the lowest HSG values (30.9±11.3 kg). Within specific groups of cardiac anomalies, patients with Fontan circulation showed the lowest (P=0.033) and patients with a morphologic right system ventricle showed higher results (P=0.004). The late mid-term survival was favorable, and 7 patients (1.8%) died in a median interval of 422 days (range, 206-1,824 days) after HGS-testing. Conclusions:This study provides the most comprehensive data on the use of HGS in CHD to date.Grip strength is an easily applicable, repeatedly usable and a cost-effective diagnostic tool to gain a quick, quantifiable assessment of the patient's current muscle function as an expression of cardiac fitness. Considering the low number of patients who died in the observation period, HGS may not be a suitable tool for survival assessment or identification of patients at risk. However, HGS is well suited to determine muscle function and strength and thereby to identify and to follow-up patients who have an increased cardiovascular risk.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

The value of hand grip strength (HGS) as a diagnostic and prognostic biomarker in congenital heart disease

Neidenbach¹,

Oberhoffer²,

Pieper³

et al. 2019

Cardiovasc. Diagn. Ther.

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“…The prevalence of malnourished patients evaluated by AND-ASPEN was 34.6%. This Consensus has been applied to other studies, in which the prevalence of malnutrition identified by the AND-ASPEN varied from 26.8% to 72.0% 16,17,19,20,24,39,40 between prospective studies conducted in hospitalized patients (critical and noncritical). The features of the sample included in these studies could explain the wide variation in the prevalence of malnutrition, especially the clinical severity and age of patients.…”

Section: Discussionmentioning

confidence: 99%

Concurrent and Predictive Validity of AND‐ASPEN Malnutrition Consensus Is Satisfactory in Hospitalized Patients: A Longitudinal Study

Burgel¹,

Teixeira²,

Leites³

et al. 2020

J Parenter Enteral Nutr

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Background Subjective Global Assessment (SGA) is the reference method to identify hospital malnutrition. The Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition (AND‐ASPEN) proposed a more objective consensus, but studies regarding its validity are still scarce. This study aimed to evaluate the concurrent and predictive validity of the AND‐ASPEN Consensus. Methods Prospective cohort conducted with hospitalized adult and elderly patients. At admission, general data were collected and patients were evaluated by SGA and AND‐ASPEN with and without handgrip strength (HGS) for nutrition diagnoses. Patients were followed up for collection of outcomes—length of hospital stay (LOS), in‐hospital death, readmission, and mortality within 6 months after being discharged. Concurrent and predictive validity were tested. Results Six hundred patients (55.7 ± 14.8 years, 51.3% males) were evaluated. The median of LOS was 10.0 (5.018.0) days and in‐hospital mortality was 2.7%. SGA identified 34.0% and AND‐ASPEN 34.6% of patients as malnourished. AND‐ASPEN had substantial agreement with SGA (κ = 0.690) and satisfactory accuracy (AUC = 0.85; 95% CI, 0.810.88). Malnutrition defined by AND‐ASPEN predicted about 1.4 times higher risk of prolonged LOS (95% CI, 1.2–1.6) and hospital readmission (95% CI, 1.2–1.8), besides 5.0 times higher risk of hospital death (95% CI, 1.3–18.8) and 6 months' death (95% CI, 2.6–9.9), in an adjusted analysis. The validity of AND‐ASPEN without HGS was also satisfactory. Conclusion AND‐ASPEN can be used for malnutrition diagnoses, even without HGS because it has satisfactory concurrent and predictive validity.

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“…In an effort to quantify muscle strength measurement, and thereby gain objectivity, instruments such as the HHD were developed. Dynamometric muscle testing (DMT) has been shown to be reliable in different populations [14][15][16], and subjective practitioner judgement of muscle strength by MMT has been shown to correlate well with muscle strength measured objectively by HHD [17][18][19][20][21]. In addition, DMT correlates well with other forms of MMT [17], and its intra-subject test-retest variability has been found to be small [22].…”

Section: Muscle Testing For Lie Detection: Grip Strength Dynamometry mentioning

confidence: 99%

Muscle testing for lie detection: Grip strength dynamometry is inadequate

Jensen

Stevens

Burls

2018

European Journal of Integrative Medicine

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Introduction: Although DMT is primarily used in the diagnosis of neuromusculoskeletal (NMS) disorders, previous studies have attempted to use other forms of manual muscle testing (MMT) to detect conditions other than NMS. For instance, muscle response testing (MRT) was used to distinguish lies (a known stressor) from truth. Therefore, it is hypothesised that DMT might be used to detect deceit as well, and the aim of this study was to investigate if grip strength via dynamometric muscle testing (DMT) could be used to distinguish lies from truth. Methods: A prospective study of diagnostic test accuracy was carried out. Twenty participants, aged 18-65 years, with healthy hands, were recruited. Participants were given a visual stimulus and followed an auditory instruction to lie or to tell the truth about the stimulus, before recording grip strength with a dynamometer. Testing proceeded in this manner until 20 DMTs were performed, 10 by each hand. We analysed the accuracy of grip strength for detecting lies. Results: The mean grip strength after true statements was found to be 24.9 kg (95% CI 20.3 to 29.6), and after false statements, 24.8 (95% CI 20.2 to 29.5), which were not statistically different (p=0.61). Conclusion: DMT via hand-held grip strength dynamometry failed to distinguish lies from truth. These results seem to suggest that strength as measured by DMT is not impacted by deceit. A limitation of this study is it is not generalisable to other types or applications of MMT or MRT or to other target conditions.

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Comparison Between Handgrip Dynamometry and Manual Muscle Testing Performed by Registered Dietitians in Measuring Muscle Strength and Function of Hospitalized Patients

Cited by 8 publications

References 12 publications

The value of hand grip strength (HGS) as a diagnostic and prognostic biomarker in congenital heart disease

The value of hand grip strength (HGS) as a diagnostic and prognostic biomarker in congenital heart disease

Concurrent and Predictive Validity of AND‐ASPEN Malnutrition Consensus Is Satisfactory in Hospitalized Patients: A Longitudinal Study

Muscle testing for lie detection: Grip strength dynamometry is inadequate

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