Grip and Muscle Strength Dynamometry Are Reliable and Valid in Patients With Unhealed Minor Burn Wounds

Abstract

Small burns are common and can cause disproportionate levels of disability. The ability to measure muscle impairment and consequent functional disability is a necessity during rehabilitation of patients. This study aimed to determine the reliability and validity of grip and muscle strength dynamometry in patients with unhealed, minor burn wounds. Grip and muscle strength were assessed three times on each side. Assessment occurred at presentation for the initial injury and again every other day (or every 5 days beyond 10 days post injury) until discharge from the service. Reliability was assessed using intraclass correlation. Minimum detectable differences were calculated for each muscle group. Validity was assessed using regression analysis, incorporating appropriate burn severity measures and patient demographics. Thirty patients with TBSA ≤15% were assessed. Both grip and muscle strength demonstrated very good reliability (intraclass correlation coefficient: 0.85-0.96). Minimum detectable differences ranged from 3.8 to 8.0 kg. Validity of both forms of dynamometry was confirmed through associations with gender for all muscle groups (P < .001). In addition, grip strength was associated with the dominant hand (P = .002) and time to assessment (P < .001). Strength was seen to improve over time in all muscle groups. Grip and muscle strength dynamometry are reliable and valid assessments of strength and are applicable for clinical use in patients who have unhealed, minor burn wounds.

Grip and Muscle Strength Dynamometry in Acute Burn Injury: Evaluation of an Updated Assessment Protocol

“…The sensitivity of MSD can be interpreted from the calculated MDD's for this group. The MDD's in this group are greater during the initial testing period when compared to our previous work which assessed MDD's on the first testing session [4]. Larger MDD's indicate greater variability and suggest that comparison between muscle strength measures, particularly at different time points of the healing continuum, should be made carefully as changes in the assessed muscle strength may be attributed to changes in a number of performance factors other than an appreciable change in strength.…”

“…5 -40% TBSA). Thus, we have demonstrated that our updated HHD testing protocol improves on the previous standard method [4] and extends the applicable TBSA range from 0 -40% TBSA, providing a reliable tool for evaluating within session muscle strength in this patient A c c e p t e d M a n u s c r i p t group. Clinically acceptable reliability was demonstrated for all assessed periods of injury acuity.…”

“…This study was undertaken to update a muscle strength testing protocol our group has previously published [4]. Updates to the protocol included new muscle group assessment for shoulder press and leg press, as well as utilizing external stabilization during testing.…”

“…The advantages of HHD include lower cost, increased time efficiency, greater portability and ease of use compared to isokinetic dynamometry [3]. Our group has previously demonstrated HHD, including muscle strength and grip strength dynamometry, to be reliable and valid in the assessment of muscle strength in patients with acute, minor burn wounds [4] and patients with a recently healed upper limb burn injury [5], though there is currently no data available for people with more severe burn injuries.…”

Evaluation of an International Classification of Functioning, Disability and Health-based rehabilitation for thermal burn injuries: a prospective non-randomized design

“…The participant will be requested to press the dynamometer with maximum force. Three trials with each hand will be carried out [19].…”