Grip strength comparison in immune‐mediated neuropathies: Vigorimeter vs. Jamar

Draak, Thomas H P; Pruppers, Mariëlle H J; Nes, Sonja I. van; Vanhoutte, Els K.; Bakkers, Mayienne; Gorson, Kenneth C.; Pol, W. Ludo van der; Lewis, Richard A.; Notermans, Nicolette C.; Nobile‐Orazio, Eduardo; Léger, J.-M.; Bergh, Peter Van den; Lauria, Giuseppe; Bril, Vera; Katzberg, Hans D.; Lunn, Michael P.; Pouget, Jean; Kooi, Anneke J. van der; Berg, Leonard H. van den; Doorn, Pieter A. van; Cornblath, David R.; Hahn, Angelika F.; Faber, Catharina G.; Merkies, Ingemar S.J.

doi:10.1111/jns.12126

Cited by 37 publications

(30 citation statements)

References 34 publications

(45 reference statements)

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“…Of these 38 articles, 27 were judged to be inappropriate following review of their titles and abstracts. Of the 11 remaining articles, 4 provided acceptable information relevant to the MCID of grip strength9,10,11,12 ) .…”

Section: Resultsmentioning

confidence: 99%

Minimal clinically important difference for grip strength: a systematic review

Bohannon

2019

J Phys Ther Sci

155

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[Purpose] The minimal clinically important difference (MCID) in grip strength is critical to interpreting changes in hand strength over time. This review was undertaken to summarize extant descriptions of the MCID for grip strength. [Methods] A search of 3 bibliographic databases as well as a hand search were completed to identify articles reporting the MCID for grip forces obtained by dynamometry. [Results] Of 38 unique articles identified as potentially relevant, 4 met the inclusion and exclusion criteria of this review. The MCIDs ranged from 0.04 kg to 6.5 kg. However, only a single study used receiver operating characteristic curve analysis and had an associated area under the curve exceeding 0.70. That study reported an MCID of 6.5 kg, which was similar to the MCIDs of another included study and minimal detectable changes reported elsewhere. [Conclusion] Additional, more rigorous, studies are needed to identify MCIDs for grip strength. In the meantime changes of 5.0 to 6.5 kg may be reasonable estimates of meaningful changes in grip strength.

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Section: Resultsmentioning

confidence: 99%

Minimal clinically important difference for grip strength: a systematic review

Bohannon

2019

J Phys Ther Sci

155

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“…IVIg-response is primarily defined in our clinical practice, by a ≥ 1-point improvement of the Overall Neuropathy Limitation Scale (ONLS) [ 7 ], excluding a grade 1 to grade 0 amelioration of the upper limb component, as not functionally meaningful. In those not meeting this requirement, patients are considered as responders if they demonstrate an improvement of ≥ 4 raw points (out of 48) of the inflammatory Rasch-built Overall Disability Scale (I-RODS) [ 8 ], and/or a ≥ 5 kg improvement of Jamar grip strength of the dominant or clinically more affected hand [ 9 , 10 ]. Additionally, we also consider improvements of lesser amplitudes of the I-RODS and Jamar grip as consistent with an IVIg-response, if both are concurrently present, with, in addition, an accompanying Medical Research Council (MRC) Sum Score (MRCSS) improvement by ≥ 2 points.…”

Section: Methodsmentioning

confidence: 99%

Clinical and economic comparison of an individualised immunoglobulin protocol vs. standard dosing for chronic inflammatory demyelinating polyneuropathy

Rajabally

Afzal

2018

J Neurol

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Background The clinical and economic implications of an individualised intravenous immunoglobulin (IVIg) protocol for chronic inflammatory demyelinating polyneuropathy (CIDP) are unknown. Comparison with standard dosing regimens has not been performed. Methods We retrospectively studied 47 IVIg-treated subjects with CIDP over 4 years with an individualised, outcome-measured, dose-modifying protocol. We evaluated responder and remission rates, clinical improvement levels and dose requirements. We compared clinical benefits and costs with those reported with standard dosing at 1 g/kg every 3 weeks. Results The IVIg-responder rate was 83% and the 4-year remission rate was 25.6%. Mean IVIg dose requirements were 22.06 g/week (SD:15.29) in patients on ongoing therapy. Dose range was wide (5.83–80 g/week). Mean infusion frequency was every 4.34 weeks (SD:1.70) and infusion duration of 2.79 days (SD:1.15). Mean Overall Neuropathy Limitation Scale improvement was 2.54 (SD:1.89) and mean MRC sum score improvement of 12.23 (SD:7.17) in IVIg-responders. Mean modified-INCAT (Inflammatory Neuropathy Cause and Treatment) score improvement was similar ( p = 0.47) and mean MRC sum score improvement greater ( p < 0.001) in our cohort, compared to the IVIg-treated arm of the ICE Study. Mean drug costs were GBP 37,660/patient/year (€ 43,309) and mean infusion-related costs of GBP 17,115/patient/year (€ 19,682), totalling GBP 54,775/patient/year (€ 62,991). Compared to standard dosing using recorded weight, mean savings were of GBP 13,506/patient/year (€ 15,532). Compared to standard dosing using dosing weight, savings were of GBP 6,506/patient/year (€ 7,482). Conclusion Our results indicate that an individualised IVIg treatment protocol is clinically non-inferior and 10–25% more cost-effective than standard dosing regimens in CIDP.

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“…A study comparing the vigorimeter versus Jamar dynamometer in immune-mediated neuropathies, including CIDP, revealed that significantly more patients preferred the vigorimeter, largely based on hand comfort during testing. 33 Validity, reliability, and responsiveness were similar between the two tools.…”

Section: Grip Strengthmentioning

confidence: 90%

Optimizing the Use of Outcome Measures in Chronic Inflammatory Demyelinating Polyneuropathy

Allen¹,

Gelinas

Lewis

et al. 2017

US Neurology

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The challenges encountered during the assessment of patients with chronic inflammatory demyelinating polyneuropathy (CIDP) are many. Ideally, CIDP outcome measures capture impairments in disability, strength, and sensory dysfunction, and quality of life (QoL). A number of outcome measures have been validated for this purpose. Disability outcomes include the adjusted inflammatory neuropathy cause and treatment (INCAT) disability score, INCAT overall disability sum score (ODSS), and overall neuropathy limitations scale (ONLS). A more sensitive disability score, the inflammatory Rasch-built overall disability scale (I-RODS), has also been validated for use in clinical trials and may better capture clinically meaningful changes in those with CIDP. Strength and sensory impairment can be assessed in a number of ways, including the INCAT sensory subscore (ISS), Medical Research Council sum score, and Martin vigorimeter or Jamar dynamometer grip strength. However, the feasibility of applying and interpreting these measures during routine daily practice has been questioned. Furthermore, these outcome measures may not reflect other factors that can impair QoL in those affected by CIDP, such as pain and fatigue. A valid, reliable, and responsive composite measure that addresses all aspects of impairment faced by patients with CIDP remains an unmet need in clinical practice.

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Grip strength comparison in immune‐mediated neuropathies: Vigorimeter vs. Jamar

Cited by 37 publications

References 34 publications

Minimal clinically important difference for grip strength: a systematic review

Minimal clinically important difference for grip strength: a systematic review

Clinical and economic comparison of an individualised immunoglobulin protocol vs. standard dosing for chronic inflammatory demyelinating polyneuropathy

Optimizing the Use of Outcome Measures in Chronic Inflammatory Demyelinating Polyneuropathy

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