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Measurement Properties of the Hand Grip Strength Assessment: A Systematic Review With Meta-analysis

  • Pavlos Bobos
    Correspondence
    Corresponding author Pavlos Bobos, PT, MSc, Dalla Lana School of Public Health, Institute of Health Policy Management and Evaluation, Department of Clinical Epidemiology and Health Care Research, University of Toronto, Canada, 4th Floor, 155 College St, Toronto, ON M5T 3M6, Canada.
    Affiliations
    Dalla Lana School of Public Health, Institute of Health Policy Management and Evaluation, Department of Clinical Epidemiology and Health Care Research, University of Toronto, Toronto, Ontario, Canada

    School of Physical Therapy, Faculty of Health Science, Western University, London, Ontario, Canada

    Collaborative Program in Musculoskeletal Health Research, Western’s Bone and Joint Institute, Western University, London, Ontario, Canada

    Roth McFarlane Hand and Upper Limb Centre, St. Joseph’s Hospital, London, Ontario, Canada
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  • Goris Nazari
    Affiliations
    School of Physical Therapy, Faculty of Health Science, Western University, London, Ontario, Canada

    Collaborative Program in Musculoskeletal Health Research, Western’s Bone and Joint Institute, Western University, London, Ontario, Canada

    Roth McFarlane Hand and Upper Limb Centre, St. Joseph’s Hospital, London, Ontario, Canada
    Search for articles by this author
  • Ze Lu
    Affiliations
    Roth McFarlane Hand and Upper Limb Centre, St. Joseph’s Hospital, London, Ontario, Canada

    School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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  • Joy C. MacDermid
    Affiliations
    School of Physical Therapy, Faculty of Health Science, Western University, London, Ontario, Canada

    Collaborative Program in Musculoskeletal Health Research, Western’s Bone and Joint Institute, Western University, London, Ontario, Canada

    Roth McFarlane Hand and Upper Limb Centre, St. Joseph’s Hospital, London, Ontario, Canada

    School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
    Search for articles by this author
Published:November 12, 2019DOI:https://doi.org/10.1016/j.apmr.2019.10.183

      Abstract

      Objective

      The aim of this study was to critically appraise, compare, and summarize the quality of the measurement properties of grip strength (GS) in patients with musculoskeletal, neurologic, or systemic conditions and healthy participants without these conditions.

      Data Sources

      We followed the Consensus-based Standards for the Selection of Health Measurement Instruments guideline. To identify studies on measurement properties of GS, we searched the MEDLINE, Embase, Cumulative Index to Nursing and Allied Health, Physiotherapy Evidence, and Cochrane Library databases from inception until June 2019. Meta-analyses were carried out using a random effects model and 95% CIs were calculated.

      Study Selection

      Studies were included if they reported at least 1 measurement property of hand GS in a population with musculoskeletal, neurologic, and systemic conditions or a healthy population without these conditions.

      Data Extraction

      The extracted data included the study population, setting, sample size, measurement evaluated, and the test interval.

      Data Synthesis

      Twenty-five studies were included with 1879 participants. The pooled results indicated excellent intraclass correlation coefficient (ICC) of 0.92 (95% CI, −0.88-0.94 for healthy participants without any conditions, ICC of 0.95 (95% CI, −0.93-0.97) for upper extremity conditions, and an ICC of 0.96 (95% CI, −0.94-0.97) for patients with neurologic conditions. Minimum clinically important difference (MCID) scores for hand GS were 5.0 kg (dominant side) and 6.2 kg (nondominant side) for patients post stroke, 6.5 kg for the affected side after distal radius fracture, 10.5 lb and 10 kPa for immune-mediated neuropathies, 17 kg for patients with lateral epicondylitis, and 0.84 kg (affected side) and 1.12 kg (unaffected side) in the carpometacarpal osteoarthritis group; MCID GS estimates were 2.69-2.44 kg in the healthy group without conditions.

      Conclusion

      Our synthesized evidence indicated that GS assessment is a reliable and valid procedure among healthy participants as well as across various clinical populations. Furthermore, our MCID summary scores provided useful information for evaluating (clinical importance) new interventions regarding hand GS.

      Keywords

      List of abbreviations:

      COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments), GS (grip strength), ICC (intraclass correlation coefficient), MDC (minimal detectable change), MDD (minimal detectable difference), MCID (minimum clinically important difference), PROM (patient-reported outcome measures), SDC (smallest detectable change), SEM (standard error of measurement)
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