Generalizability of Grip Strength Measurements in Patients with Tennis Elbow

Stratford, Paul W.; Norman, Geoffrey R.; McIntosh, John M.

doi:10.1093/ptj/69.4.276

Cited by 68 publications

(38 citation statements)

References 7 publications

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“…For elbow extension and flexion, we can be 95% confident that differences greater than 2.09 and 3.14 N, respectively, represent true change. The reliability (ICC>0.97) and validity of pain-free grip (PFG) strength have been previously confirmed 11–13…”

Section: Methodsmentioning

confidence: 86%

Elbow flexor and extensor muscle weakness in lateral epicondylalgia

Coombes

Bisset²,

Vicenzino³

2011

Br J Sports Med

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Word count 2402Elbow flexor and extensor muscle weakness in lateral epicondylalgia. AbstractObjective To evaluate whether deficits of elbow flexor and extensor muscle strength exist in lateral epicondylalgia in comparison to a healthy control population. Design Cross-sectional study Participants 150 participants with unilateral lateral epicondylalgia were compared with 54 healthy control participants. Main Outcome Measures Maximal isometric elbow flexion and extension strength were measured bilaterally using a purpose built standing frame such that gripping was avoided. Results We found significant side differences in elbow extensor (-6.54N, 95% CI -11.43, -1.65, p=0.008, SMD -0.45) and flexor muscle strength p=0.009,) between lateral epicondylalgia and control groups. Within the lateral epicondylalgia group, only elbow extensor muscle strength deficits between sides was significant (affected -unaffected: -2.94N, 95% CI -5.44, -0.44).

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Section: Methodsmentioning

confidence: 86%

Elbow flexor and extensor muscle weakness in lateral epicondylalgia

Coombes

Bisset²,

Vicenzino³

2011

Br J Sports Med

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“…Another outcome measure mentioned in the literature for patients with lateral epicondylitis is pain-free grip strength. Both pain-free and maximal grip strength appear to be reliable (Stratford et al, 1989). However, it applies to both methods that there is no insight into the perceived exertion during gripping.…”

Section: Discussionmentioning

confidence: 99%

“…To measure maximal grip strength, a Jamar dynamometer was used. Maximal grip strength appears to be a reliable outcome measure in patients with lateral epicondylitis (Stratford et al, 1989;Shechtman et al, 2003). The grip strength was measured three times on the involved side.…”

Section: Outcome Measuresmentioning

confidence: 99%

The effect of a forearm/hand splint compared with an elbow band as a treatment for lateral epicondylitis

Streek

Schans

Greef

et al. 2004

Prosthetics &Amp; Orthotics International

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The aim of the present study was to compare the effect of a new prefabricated Thämert forearm/hand splint with the effect of a simple elbow band as a treatment for lateral epicondylitis. Forty-three (43) patients that met the inclusion criteria were randomly assigned to the elbow band group and the splint group. They wore the orthotic devices for 6 weeks. Outcome measures were obtained at baseline and directly after the intervention. These outcome measures were maximal grip strength on the involved side with a pain scale from 1 to 10 to determine the extent of pain during gripping, and the PatientRated Forearm Evaluation Questionnaire (PRFEQ). Analysis of variances with repeated measures, a Mann Whitney test and multiple linear regression analysis were used to compare the two groups. Main effect for time was significant for maximal grip strength and sum scores on the PRFEQ, but no differences between groups were found, even when a distinction between acute and chronic symptoms was made. Change in pain score during gripping did not differ significantly between the groups. A multiple linear regression analysis showed that the use of the splint did not significantly contribute to the prediction of change in maximal grip strength and in overall PRFEQ.

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“…4,5 Although the literature contains several reports on the reproducibility of grip strength in healthy subjects, the reproducibility of grip strength in patients with lateral epicondylitis has received little attention. Stratford et al 6 investigated the intraobserver reliability of grip strength in 35 patients with tennis elbow and reported high intraobserver reliability coefficients for pain-free grip strength (.97) and maximum grip strength (.98). However, information on the interobserver reliability of grip strength is still lacking.…”

mentioning

confidence: 99%

“…However, information on the interobserver reliability of grip strength is still lacking. In their study, Stratford 6 used the Smedley hand dynamometer, although the Jamar hand dynamometer is more frequently used by hand therapy clinics.…”

mentioning

confidence: 99%

Interobserver reproducibility of the assessment of severity of complaints, grip strength, and pressure pain threshold in patients with lateral epicondylitis

Smidt

Windt

Assendelft

et al. 2002

Archives of Physical Medicine and Rehabilitation

257

159

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ABSTRACT. Smidt N, van der Windt DA, Assendelft WJ, Mourits AJ, Devillé WL, de Winter AF, Bouter LM. Interobserver reproducibility of the assessment of severity of complaints, grip strength, and pressure pain threshold in patients with lateral epicondylitis. Arch Phys Med Rehabil 2002;83:1145-50.Objective: To evaluate the interobserver reproducibility of the assessment of severity of complaints, grip strength, and pressure pain threshold in patients with lateral epicondylitis in primary care.Design: Two physiotherapists assessed independently, and in randomized order, the severity of complaints scored on an 11-point numeric rating scale, pain-free grip strength, maximum grip strength, and pressure pain threshold.Setting: Primary care center in the Netherlands. Participants: Fifty patients were assessed by both physiotherapists.Interventions: Not applicable. Main Outcome Measures: Intraclass correlation coefficients (ICCs) and 95% confidence intervals (CIs) were calculated to assess interobserver reliability. The Bland and Altman method was used to assess interobserver agreement, which included calculation of the mean difference between the observers (d ), the 95% CI for d, the standard deviation of the differences, and the 95% limits of agreement. Finally, the smallest detectable difference (SDD) was calculated.Results: The ICC for the severity of complaints was .90. The ICCs for the pain-free grip strength and maximum grip strength were .97 and .98, respectively. The pressure pain threshold showed a lower reliability (ICCϭ.77). The interobserver agreement for all outcome measures was good, but systematic differences in assessment between the physiotherapists were found for the maximum grip strength and pressure pain threshold. For pressure pain threshold, the SDD was clearly larger than the predefined acceptable difference of 10% of the total range of measurement.Conclusions: The interobserver reliability of severity of complaints and grip strength was excellent, whereas the pressure pain threshold showed unsatisfactory reliability. Grip strength and overall assessment of the severity of complaints are useful and reliable measures for the assessment of lateral epicondylitis. Pain-free grip strength, in particular, is relatively easy to perform and has been shown to be associated with other measures of functional disability in patients with lateral epicondylitis. We, therefore, recommend the use of pain-free grip strength in both research and clinical practice.

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Generalizability of Grip Strength Measurements in Patients with Tennis Elbow

Cited by 68 publications

References 7 publications

Elbow flexor and extensor muscle weakness in lateral epicondylalgia

Elbow flexor and extensor muscle weakness in lateral epicondylalgia

The effect of a forearm/hand splint compared with an elbow band as a treatment for lateral epicondylitis

Interobserver reproducibility of the assessment of severity of complaints, grip strength, and pressure pain threshold in patients with lateral epicondylitis

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