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)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 12, 2019
Footnotes
Disclosures: none.
Clinical Trial Registration No.: CRD42019117877.
Pavlos Bobos was supported by Canadian Health Research Institute’s Doctoral Award scholarship. Goris Nazari was supported by the Transdisciplinary Bone & Joint Training Award, the Collaborative Training Program in Musculoskeletal Health Research, Western University London On Canada. Joy C. MacDermid was supported by a Canadian Institutes of Health Research Chair in Gender, Work and Health and the Dr James Roth Research Chair in Musculoskeletal Measurement and Knowledge Translation.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
