Grip strength measured by high precision dynamometry in healthy subjects from 5 to 80 years

Is the handgrip pressure influenced by the same factors in typical children and adolescents and those with spina bifida?

OBJECTIVE

To investigate the factors influencing handgrip pressure (HGP) in typical children and adolescents and those with spina bifida (SB).

METHODS

This cross-sectional study enrolled 126 typical participants and 58 with SB, aged 8-16 years, categorized into subgroups: typical children (typical prepubertal; n = 20), typical adolescents (typical pubertal and post-pubertal; n = 106), SB children (SB prepubertal; n = 11), and SB adolescents (SB pubertal and post-pubertal; n = 47). Data on sex, height (or wingspan), lean and fat body mass, and levels of physical activity and spinal cord injury were collected. Participants performed three maximal voluntary isometric contractions of HGP using a bulb dynamometer. Multiple linear regression analyses examined the relationship between variables and HGP.

RESULTS

In typical children, decreases in height, fat and lean body mass were associated with decreased HGP. In typical adolescents, females exhibited higher HGP than males, and increases in lean body mass and height were positively associated with HGP; and sedentary individuals exhibited higher HGP compared to active counterparts. In SB adolescents, increases in fat and lean body mass were associated with higher HGP, and greater physical activity was associated with stronger HGP. Participants with sacral injury level showed higher HGP than those with thoracic injury level. No association was observed for SB children.

CONCLUSION

Except for SB children, various factors, mainly the lean body mass, significantly influenced the HGP in all groups. When the outcome is HGP, it is important to monitor body composition and physical activity in typical children and adolescents and those with SB.

Establishing the reliability and validity for GripAble: A handheld sensor-based dynamometry device

Introduction

Evaluation of maximum grip strength (MGS) is commonly conducted to guide intervention planning and evaluate treatment outcomes for individuals with hand or upper limb impairments. While the hydraulic Jamar dynamometer is recognised as the gold standard measurement instrument, it has several limitations and there has not been a consensus on whether alternative instruments can replace or complement it. This study aimed to determine whether a new electronic rehabilitation device, the GripAble, is a reliable and valid instrument for measuring the MGS of healthy adults when compared to the gold standard hydraulic Jamar dynamometer. It also sought to compare the user's experience when using the two instruments.

Methods

Fifty-five healthy adults completed two MGS assessments ten minutes apart using a standardised protocol. Test-retest and inter-instrument reliability were evaluated using intraclass correlation coefficient. Concurrent validity was established using a Bland-Altman plot. Relationship and level of agreement between measurements on the two devices were evaluated. Participants' user experience was explored through a quantitative survey.

Results

The GripAble was found to have excellent test-retest reliability (ICC = 0.971-0.975) and good-to-excellent inter-instrument reliability (ICC = 0.898-0.922) with the Jamar dynamometer. Its measurement output is equivalent to approximately 63.3% of that of the Jamar dynamometer. The mean difference value between the measurements on the two devices was 9.44 kg (SD = 4.47). Users preferred the GripAble.

Discussion

While the GripAble is a reliable MGS assessment instrument, it should not be used interchangeably with the Jamar dynamometer for repeated measurements of the same individual owing to the differences in their readings.

Normative values of grip and pinch strength and their predictor factors: PERSIAN cohort study of healthcare staff

PURPOSE

The present study aims to provide normative values for Hand Grip Strength (HGS) and Hand Pinch Strength of healthcare staff and evaluate key body anthropometric predictors of these strengths.

METHODS

This cross sectional study was conducted on 2,337 healthcare staff. HGS and pinch strength were assessed for both hands using a hydraulic hand dynamometer and pinch gauge. Descriptive data were reported for dominant and non-dominant HGS and pinch strength, after stratification by gender, age, and height. Multivariatelinear regression analysis was performed to assess predictor variables.

RESULTS

The maximum HGS values were identified in men aged 35 to 40, measuring 38.00 ± 7.81 kg, and in women aged 50 to 55, measuring 22.20 ± 4.13 kg. The highest pinch strength values were recorded in men aged 45 to 50, with measurements of 7.16 ± 1.48 kg, and in women aged 35 to 40, with measurements of 4.24 ± 1.15 kg. The predictor variables for dominant HGS and pinch strength exhibited 59% and 51% prediction for variations in dominant HGS and pinch strength, respectively, using gender, height, and wrist circumference as predictors. Height (for grip: dominant hand: β = 0.33, CI [0.28, 0.37]; for pinch: dominant hand: β = 0.04, CI [0.02, 0.05]) was the most effectively correlated anthropometric variable.

CONCLUSION

The findings demonstrate differences in HGS and pinch strength among different gender and age groups. Multiple linear regression analysis highlights the crucial role of anthropometric variables in evaluating hand strength. These results can provide guidance for future research and clinical assessments.

TRIAL REGISTRY NUMBER

Not applicable.

LEVEL OF EVIDENCE

Level III (analytical cross-sectional study on big sample size).

A Comparison of Two-Handed Face-Mask Ventilation Techniques by Trainees: A Prospective Observational Study

BACKGROUND

Effective face-mask ventilation (FMV) is a crucial step for oxygenation after anesthesia induction and prior to airway instrumentation. Preceding literature demonstrates that specific physical characteristics of providers affect tidal volume (Vt) delivery during FMV. In difficult ventilation scenarios, FMV success rates are improved using two-handed techniques, CE or VE. We hypothesized that anesthesia trainees' Vt delivery efficacy would differ with each technique and related to their hand size.

METHODS

In this prospective crossover trial, 38 anesthesia trainees performed FMV on elective surgical patients after induction of general anesthesia with both CE and VE techniques. We recorded differences in delivered Vt with each method and analyzed its relation to multiple trainee hand size measurements, including palm circumference, hand length, and hand span.

RESULTS

 Thirty-eight operators (females 55.3%, n=21, males 44.7%, n=17) performed FMV on 38 patients (age 48.1+16.7 years, male sex 65.8%, n=25). Larger median Vts were obtained with VE vs. CE (10.0 (5.8-13.6) mL/kg vs. 11.9 (8.9-14.5) mL/kg, p = 0.008) without a significant change in achieving TV of 4 mL/kg (15% vs. 8%, p=0.32). The differences in VE and CE were inversely proportional to hand measurements (circumference: R-square = 0.15, p=0.02, length: R-square = 0.24, p=0.002, and span: R-square = 0.23, p=0.002). When stratifying by quartile of hand size, significant differences were observed as follows: hand size (circumference: first quartile p=0.039, hand length: first quartile p=0.018, second quartile p=0.028, hand span: second quartile p=0.001).

CONCLUSIONS

 In novice anesthesiology providers, hand size is correlated with delivered Vt during two-hand FMV. The VE modification increases the delivery of Vt, especially in trainees with smaller hands.

Sensor-assessed grasping time as a biomarker of functional impairment in rheumatoid arthritis

Quantifying physical impairment in rheumatoid arthritis (RA) is important to determine disease burden and disability. Therefore, we aimed to define hand function impairments in RA patients using an opto-electronic measurement system (OMS). In this cross-sectional pilot study, spatio-temporal and hand segment data were collected during the fine motor skill Moberg Picking-Up Test (MPUT) and two elementary hand movement tasks in RA patients and healthy controls (HC) using a marker-based OMS. The duration of two MPUT movement phases (grasping, transporting 12 objects) and kinematic characteristics during the elementary movements were evaluated. We analyzed between-group differences using linear mixed-effects models accounting for within-participant clustering of hands and adjusting for age and sex. Measurements were obtained from 24 RA and 23 HC. The mean duration of the grasping phase of MPUT was longer in RA patients compared to HC while transporting times were identical, showing a significant group-phase interaction (p < 0.001). Interphalangeal joint angle ratios were similar in RA and HC (p > 0.05) with a lower ratio in both groups for the task thumb-finger opposition compared to flexion of joints. In RA patients especially grasping objects was impaired, and performance time for a subset of objects may serve as a quantitative biomarker of functional impairment.

Reliability and validity of the hand-held dynamometer "NOD": a new instrument for assessment of isometric grip strength

INTRODUCTION

Hand grip strength (HGS) is an important measure in a physiotherapy assessment and for this purpose it is necessary to have valid and reliable instruments to measure it. In this study we aimed at investigating the reliability, validity, and agreement of the new hand-held dynamometer NOD (OT-Bioelettronica, To-Italy) compared to Jamar® hydraulic dynamometer (JD), the gold standard.

METHODS

Fifty healthy subjects were selected; 9 trials for the dominant hand and 9 trials for the non-dominant hand were administrated to each of them: 3 trials of HGS with the JD in rung #3, 3 trials with the JD-adapted-grip (like the NOD one), and 3 trials with NOD. To verify the reliability of NOD, the Intraclass Correlation Coefficient (ICC 3,1) was calculated with a mixed effects model with the addition of adjustment variables (age, gender, dominant / non-dominant limb, trials). The model used single HGS measurements to estimate variance components, so reflecting both degree of correspondence and agreement among devices. To assess concurrent validity NOD was compared to the "gold standard" JD, in terms of ICCs and through Pearson correlation. The agreement between the methods of measurement was calculated with the Limits of Agreement (LoA) and the plots of Bland-Altman.

RESULTS

All ICCs show high inter-reliability; the results are very similar for both dynamometers. The value of the adjusted ICC of NOD was 0.90. For validity, Pearson correlations of NOD towards JD and JD-adapted-grip were high (r = 0.87 and 0.88). However, the LoA and the plots of Bland-Altman demonstrated that there is no agreement between NOD and JD and between NOD and JD-adapted-grip, with NOD showing lower mean scores than JD.

CONCLUSIONS

NOD is a reliable and valid instrument for HGS. However, even if it cannot be considered interchangeable with JD because there is no agreement between them in free-living adults, NOD is easier to carry than other dynamometers, it has a Bluetooth® connection with a free App and it is a multi-purpose tool that should be considered both in daily practice and in clinical settings.

Accuracy and Reliability of Grip Strength Measurements: A Comparative Device Analysis

Background: Grip strength is widely used as a surrogate parameter for functional status. The current gold standard, the JAMAR® Hydraulic Dynamometer (JAMAR® Hydraulic), presents challenges for individuals with painful finger joints or low grip strength. Therefore, the objective of this observational study was to assess comparability across the JAMAR® Smart, the Martin Vigorimeter and the gold standard. Additionally, the intrasubject and intersession reliability of all three devices were examined, which are essential for quality control before generating normative data. Methods: Forty healthy participants (aged 37.0 ± 11.3 years) were included, and a subset of 20 participants was randomly selected for retesting. Grip strength testing involved five attempts per measurement device. Results: Intrasubject reliability was excellent (ICC3,1: 0.91-0.97), and a strong correlation (ICC3,1: 0.90-0.98) was found between the first attempt and the best of five as well as between the best of two or three attempts and the best of five, demonstrating robust reliability across multiple measures. Intersession reliability was good to excellent (ICC3,1: 0.85-0.97) across all three devices, which was confirmed by Bland-Altman analysis. The PCC (r) revealed moderate to very strong agreement with the current gold standard JAMAR® Hydraulic (r = 0.68-0.98), with increased differences between the Martin Vigorimeter and the JAMAR® Hydraulic measurements, particularly at low and high values. Conclusions: The proposed devices are suitable for test-retest analysis with 2-3 attempts. Despite high correlations between all three devices, the diverging levels of agreement between the Martin Vigorimeter and the established gold standard warrant caution against using these devices interchangeably.

Effect of traditional Chinese Yijinjing exercise on hand dysfunction in rheumatoid arthritis patients: a randomized controlled trial

Introduction

Rheumatoid arthritis (RA) patients often experience significant hand dysfunction. Yijinjing, a traditional Chinese exercise, has been recognized for its benefits to mind-body health. This study aimed to evaluate the efficacy and safety of Yijinjing in improving hand dysfunction among individuals with RA.

Methods

This research was conducted as a single-center, outcome-blinded, randomized controlled trial. A total of 66 eligible RA participants were randomly assigned in a 1:1 ratio to either the Yijinjing exercise group (YJJG) with sessions conducted three times per week over a 12-week period or the control group (CG), which maintained ordinary activities. Various outcomes were assessed, including the Michigan Hand Outcomes Questionnaire (MHQ), handgrip strength, active range of motion (AROM), RA disease activity, the Health Assessment Questionnaire Disability Index (HAQ-DI), levels of anxiety and depression, and wrist ultrasound, all of which were collected at baseline and the week 12.

Results

At the end of the 12 weeks, the YJJG demonstrated significant improvements in MHQ scores compared to the CG (p < 0.05), alongside enhancements in handgrip strength and AROM, specifically in wrist extension, radial deviation, and metacarpophalangeal flexion (p < 0.05). Wrist ultrasound scores did not exhibit a significant increase in the YJJG, meaning no inflammation aggravation (p > 0.05). Additionally, morning stiffness duration, Disease Activity Score 28-ESR (DAS28-ESR), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels showed significant improvement in the YJJG (p < 0.05). Both groups reported enhancements in quality of life, as well as reductions in anxiety and depression scores, with the YJJG displaying greater improvements overall (p < 0.05). Importantly, no adverse events or significant abnormalities in vital signs were observed in either group.

Conclusion

Yijinjing exercise may effectively enhance hand function, handgrip strength, and flexibility in RA patients with low disease activity. Furthermore, it appears to improve quality of life and reduce anxiety and depression without exacerbating joint inflammation.

Clinical trial registration

https://clinicaltrials.gov/study/NCT05527158, Identifier NCT05527158.

Pressure Sensors for Evaluating Hand Grasp and Pinch

This study addresses the need for highly sensitive tools to evaluate hand strength, particularly grasp and pinch strength, which are vital for diagnosing and rehabilitating conditions affecting hand function. Current devices like the Jamar dynamometer and Martin Vigorimeter, although reliable, fail to measure extremely low force or pressure values required for individuals with severe hand impairments. This research introduces a novel device, a modified Martin Vigorimeter, utilizing an ultra-soft latex chamber and differential pressure measurement to detect minute pressure changes, thus significantly enhancing sensitivity. The device offers a cost-effective solution, making advanced hand strength evaluation more accessible for clinical and research applications. Future research should validate its accuracy across diverse populations and settings, exploring its broader implications for hand rehabilitation and occupational health.

Interrater Reliability and Precision of a Novel Hand Strength Assessment and Treatment Device: The GripAble

IMPORTANCE

Occupational therapy practitioners need modern tools for the assessment of maximal grip strength in clinical and remote settings.

OBJECTIVE

To establish the (1) interrater reliability and (2) precision of the GripAble among three raters with different expertise in occupational therapy when testing healthy participants, and to (3) evaluate the relative reliabilities of different approaches to estimating grip strength (i.e., one trial, mean of two trials, and the mean of three trials).

DESIGN

Measurement study.

SETTING

Minnesota Translational Musculoskeletal and Occupational Performance Research Lab, University of Minnesota, Minneapolis.

PARTICIPANTS

Thirty volunteers, age ≥18 yr, without any hand problems.

OUTCOMES AND MEASURES

Using GripAble, three occupational therapy raters with varied experience measured the maximal grip strength of the dominant and nondominant hands of all participants. Using the mean of three trials when testing grip strength with GripAble adds precision.

RESULTS

GripAble has excellent interrater reliability (i.e., intraclass correlation coefficient > .75) and acceptable precision (minimal detectable change < 15%) among healthy adults.

CONCLUSIONS AND RELEVANCE

GripAble allows occupational therapy practitioners with different experiences to assess grip strength in healthy hands quickly, precisely, and with excellent reliability. Additional research is needed on its psychometrics in clinical populations and capacities in remote monitoring and exergaming. Plain-Language Summary: The results of this study show that grip strength, an important biomarker and commonly assessed construct in occupational therapy, can be evaluated reliably, precisely, and rapidly with GripAble. The use of GripAble by occupational therapy practitioners in clinical settings may help to build an infrastructure for remote measurements and exergaming interventions in the future.

Reliability and Validity of the Martin Vigorimeter for Grip Strength Measurement in Korean Adults

Background

Grip strength is important for fine motor skills, and one of the measurement tools for grip strength is the Martin Vigorimeter (MV) dynamometer. Studies on establishing the reliability and validity of the MV in Koreans are limited. We aimed to establish the reliability and validity of the MV for grip strength measurement in healthy Korean adults by comparing it with the Jamar dynamometer, the standard tool used by the American Society of Hand Therapists.

Methods

In total, 99 healthy participants (50 men and 49 women) were enrolled. Grip strength was measured using the Jamar dynamometer and MV. Reliability and validity were assessed using the intraclass correlation coefficient (ICC) and minimal detectable change (MDC). The correlation between the measurements of the instruments was analyzed using Pearson's correlation. The effect of hand anthropometry was evaluated, and the conversion equation between the instruments was calculated.

Results

MV showed excellent reliability (ICC > 0.90, p < 0.001) and validity with a high correlation (0.7 ≤ r < 0.9) with the Jamar dynamometer. The MDC was acceptable for detecting minimal clinically important differences (< 19.5%) in both instruments (Jamar: 3.4%-6.7%, MV: 3.8% to 6.3%). The grip strength measured using the MV was independent of hand anthropometry, unlike that using the Jamar dynamometer.

Conclusions

This study provides insights into the relationship between the Jamar and MV instruments for measuring grip strength in Koreans. The MV is a viable alternative to the Jamar dynamometer in Koreans, offering not only reproducible and reliable measurements of grip strength but also the advantage of being unaffected by variations in hand anthropometry.

Population-specific equations of age-related maximum handgrip force: a comprehensive review

Background

The measurement of handgrip force responses is important in many aspects, for example: to complement neurological assessments, to investigate the contribution of muscle mass in predicting functional outcomes, in setting realistic treatment goals, evaluating rehabilitation strategies. Normative data about handgrip force can assist the therapist in interpreting a patient's results compared with healthy individuals of the same age and gender and can serve as key decision criteria. In this context, establishing normative values of handgrip strength is crucial. Hence, the aim of the this study is to develop a tool that could be used both in rehabilitation and in the prevention of work-related musculoskeletal disorders. This tool takes the form of population-specific predictive equations, which express maximum handgrip force as a function of age.

Methodology

In order to collect data from studies measuring maximum handgrip force, three databases were searched. The search yielded 5,058 articles. Upon the removal of duplicates, the screening of abstracts and the full-text review of potentially relevant articles, 143 publications which focussed on experimental studies on various age groups were considered as fulfilling the eligibility criteria. A comprehensive literature review produced 1,276 mean values of maximum handgrip force.

Results

A meta-analysis resulted in gender- and world region-specific (general population, USA, Europe and Asia) equations expressing maximum force as a function of age. The equations showed quantitative differences and trends in maximum handgrip force among age, gender and national groups. They also showed that values of maximum handgrip force are about 40% higher for males than for females and that age-induced decrease in force differs between males and females, with a proved 35% difference between the ages of 35 and 75. The difference was lowest for the 60-64 year olds and highest for the 18-25 year-olds. The equations also showed that differences due to region are smaller than those due to age or gender.

Conclusions

The equations that were developed for this study can be beneficial in setting population-specific thresholds for rehabilitation programmes and workstation exposure. They can also contribute to the modification of commonly used methods for assessing musculoskeletal load and work-related risk of developing musculoskeletal disorders by scaling their limit values.

Normative values of skeletal muscle mass, strength and performance in the Indian population

BACKGROUND AND OBJECTIVES

Skeletal muscle is characterized by its mass, strength and performance. These normative values are pivotal in defining sarcopenia. Sarcopenia is associated with poor outcome of numerous medical and surgical conditions. This study aimed to establish normative benchmarks for skeletal muscle mass, strength and performance within the context of the Asian (Indian) population.

METHODS

Our investigation utilized the computed tomography (CT) skeletal muscle index (SMI), handgrip strength (HGS), gait velocity and chair-stand test to construct reference values for muscle characteristics in the Indian population.

RESULTS

The SMI analysis incorporated 1485 cases of acute abdomen (54.7%) males). The calculated SMI (kg/m2) was 38.50 (35.05-42.30) in males and 36.30 (32.20-41.20) in females (p = 0.510). The study also involved 3083 healthy individuals (67.6% males) evaluated for muscle strength and performance between August 2017 and August 2018. Notably, HGS (kg force) was recorded at 34.95 (26.50-43.30) in males and 25.50 (18.60-31.20) in females (p < 0.001). Gait velocity (metres/second) exhibited values of 1.25 (1.04-1.56) in males and 1.24 (1.03-1.56) in females (p = 0.851). Additionally, chair-stand test (seconds) results were 10.00 (9.00-13.00) in males and 12.00 (10.00-14.00) in females (p < 0.001).

CONCLUSIONS

The investigation determined that males had greater muscle strength and performance than females. But gender wise, there was no significant difference in muscle mass. Interestingly, our population's muscle parameters were consistently lower compared to western literature benchmarks. These normative values will help to define sarcopenia parameters in our population, which have prognostic value in multiple ailments.

The reliability of a Biometrics device as a tool for assessing hand grip and pinch strength, in a Polish cohort-A prospective observational study

The aim of the study was to assess the external and internal compatibility of the Biometrics E-LINK EP9 evaluation system device in the area of hand grip and pinch strength in the Polish population. The testing of hand grip and pinch strength was carried out among 122 healthy students. Two examiners performed hand grip and pinch strength measurements with a Biometrics E-LINK EP9 evaluation system device. Measurements were made for the right and left hands. The same people were tested again two weeks later, under the same conditions. The scores of one rater on the first and second tests were compared for reproducibility, and the scores of the two raters were compared to assess the reliability of the instrument. The measurements were found to be highly consistent both between the investigators and between the tests in the hand grip dynamometer test. The findings show high values of the Pearson's correlation coefficient equal or close to 1, as well as the interclass correlation coefficient (ICC) >0.9. Analysis of pinch strength measurements performed using the pinchmeter also found high values of the Pearson's correlation coefficient close to 1, as well as the interclass correlation coefficient >0.9; this reflects high agreement between the measurements performed by two investigators as well as assessments performed by one investigator at time intervals. These findings were confirmed by analyses performed using Bland-Altman plots. The measurements made with the Biometrics E-link EP9 evaluation system show high internal and external consistency in hand grip and pinch strength assessment. Biometrics E-link EP9 can be recommended for daily clinical practice.

Testing Biological and Psychological Pathways of Emotion Regulation as a Primary Mechanism of Action in Yoga Interventions for Chronic Low Back Pain: Protocol for a Randomized Controlled Trial

BACKGROUND

Interventions that promote adaptive emotion regulation (ER) skills reduce pain in patients with chronic pain; however, whether the effects of yoga practice on chronic low back pain (CLBP) are due to improvements in ER remains to be examined.

OBJECTIVE

This study will test whether the effects of yoga on CLBP (improved pain severity and interference) are mediated by improved ER, the extent to which effects are related to specific aspects of ER, and the role of pain sensitization as a mediator or moderator of effects. In this study, pain sensitization will be assessed by quantitative sensory testing and gene expression profiles to examine whether pain sensitization moderates yoga's effects on pain or whether yoga and ER abilities reduce pain sensitization, leading to decreased pain severity and interference.

METHODS

For this 2-arm parallel group blinded randomized controlled trial, we will enroll 204 adults with CLBP who will be randomized to receive the yoga (n=102) or a control stretching and strengthening (n=102) intervention, which are delivered via web-based synchronous biweekly 75-minute sessions over 12 weeks. Participants are encouraged to practice postures or exercises for 25 minutes on other days using accessible prerecorded practice videos that are sent to participants digitally. Participants will be assessed at 5 time points: baseline, midintervention (6 weeks), postintervention (12 weeks), and 3- and 6-month follow-ups. Assessments of ER, pain severity and interference, pain sensitivity including somatosensory and gene expression profiles, and physical strength and flexibility will be conducted at each visit. The fidelity of the interventions is assessed using a manualized checklist to evaluate recorded group sessions to ensure consistent instructor delivery.

RESULTS

The primary outcome will be the mean change in pain severity as measured by the Brief Pain Inventory-Short Form at 12 weeks. The primary mechanism of action is ER measured by change in the Difficulties in Emotion Regulation Scale total score. Secondary outcomes include pain sensitivity, physical strength and flexibility, pain interference, and quality of life. A mediation path analysis and series of moderated mediation path analyses will be conducted to test the study hypotheses. As of January 2024, we have enrolled 138 participants. We expect the study to be completed by May 2025.

CONCLUSIONS

The study will provide important data for evaluating whether improvements in ER are responsible for reduced pain perception and pain sensitivity as well as increased quality of life in the context of chronic pain. The study findings have important implications for determining the mechanism of action for yoga and possibly other mind-body interventions as nonpharmacological therapies for pain management. The results of the study will inform the content, delivery, and measures for intervention trials involving yoga as a modality for relieving pain and improving function.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04678297; https://clinicaltrials.gov/study/NCT04678297.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/56016.

Measuring handgrip strength in school children: inter-instrument reliability between Takei and Jamar

The aim of this study was to determine inter-instrument reliability between Takei and Jamar dynamometers in school children. Fifty-six five grade participants aged eleven to twelve (n = 32 boys, n = 24 girls) performed handgrip strength test on two different occasions, with a 5-day gap between them, as test-retest. The Pearson correlation coefficient showed very large to almost perfect correlation between both devices (r = 0.76-0.91) which was graphically confirmed by Bland-Altman method. Test-retest also showed high reliability (ICC = 0.78-0.85) for Jamar and Takei. Trivial, nonsignificant differences (p > 0.05) were observed between for test-retest trials for Takei left hand (ES = 0.04), right hand (ES = 0.12) and Jamar left hand (ES = 0.15). According to the results, both the Jamar and Takei dynamometers are valid and reliable for measuring schoolchildren, and both devices may be used to assess a student's handgrip strength for this age group.

The determination of sarcopenia in older adults using a practical measure

BACKGROUND

Many older adults are at risk of sarcopenia, a gradual loss of muscle mass affecting muscle strength and physical function, which can lead to adverse health consequences deteriorating their independence. However, the detection could be delayed due to the requirement of many measures, including a complex imaging modality. Thus, an exploration for a practical community- or home-based measure would be helpful to identify at-risk older adults and begin the timely management.

OBJECTIVE

To explore the ability of the upper limb loading during a seated push-up test (ULL-SPUT) to determine the presence of sarcopenia in community-dwelling older adults.

METHODS

Older adults (n= 110; 62 females, average age approximately 77 years) were cross-sectionally assessed for sarcopenia using standard measures (handgrip strength, appendicular skeletal muscle mass, and walking speed) and the ULL-SPUT.

RESULTS

Data from standard measures indicated that 44 participants had sarcopenia. The ULL-SPUT index of < 16.9 kg/m2 for females (sensitivity = 86%, specificity = 78%, area under the receiver operating characteristic curve [AUC] = 0.85) and < 19.7 kg/m2 for males (sensitivity = 73%, specificity = 69%, AUC = 0.83) could optimally identify participants with sarcopenia.

CONCLUSION

The ULL-SPUT index could be used to screen and monitor older adults with sarcopenia in various clinical, community, and home settings. This practical measure may be accomplished using a digital bathroom scale on a hard, even surface. Outcomes would identify an adult who should undergo further confirmation of sarcopenia through standard measures or the initiation of timely management to promote treatment effectiveness.

The diagnostic cut-off points for components of sarcopenia in Finnish Caucasian women: A retrospective cross-sectional study

Objectives

To determine the diagnostic cut-off values of components for sarcopenia in Caucasian women.

Methods

The present retrospective cross-sectional study based on the REFERENCE sample included 400 healthy women aged 20 to 40 years, and the OSTPRE sample included 344 women aged 63 to 75. The subjects of the OSTPRE population were re-measured five and ten years later after the baseline. Both samples underwent grip strength (GS), quadriceps strength (QS), and total-body DXA (TB-DXA) measurements, from which Relative Skeletal Muscle Mass Index (RSMI) was calculated.

Results

In the REFERENCE population, the -1 SD / -2 SD cut-off points were for RSMI 5.8 kg/m2 / 5.1 kg/m2, for GS 32.0 kg / 26.4 kg, and for QS 39.8 kg / 29.8 kg. The prevalence of under -2 SD distributions in REFERENCE were: RSMI 1.8%, GS 1.3%, and QS 2.0%, and in OSTPRE (15/20/25 years measurements): RSMI 1.2 %/1.9 %/0.5 %, GS 52.2%/42.3%/48.8%, and QS 47.4%/55.2%/not available. The distributions of GS and QS were statistically significantly different between REFERENCE and all OSTPRE measurement points (p<0.001 in Chi-squared).

Conclusions

The diagnostic cut-offs for components of sarcopenia are RSMI 5.1 kg/m2, grip strength 26.4 kg, and quadriceps strength 29.8 kg in Finnish Caucasian women.

The Use of Practical Measures to Determine Body Composition of Older People

Background

Older adults frequently experience body composition changes-decreased lean body mass (LBM) and bone mineral content (BMC), along with increased body fat mass (FM)-which affect their health and independence. However, the need for standard complex and costly imaging modalities could delay the detection of these changes and retard treatment effectiveness. Thus, this study explored the ability of practical measures, including simple muscle strength tests and demographic data, to determine the body composition of older adults.

Methods

Participants (n = 111, with an average age of 77 years old) were cross-sectionally assessed for the outcomes of the study, including upper limb loading during a seated push-up test (ULL-SPUT), hand grip (HG) strength test and body composition.

Results

The ULL-SPUT significantly correlated with body composition (r or rs, = 0.370-0.781; P < 0.05), particularly for female participants and was higher than that found for the HG strength test (rs = 0.340-0.614; P < 0.05). The ULL-SPUT and HG strength test, along with gender and body mass index (BMI), could accurately determine the LBM and BMC of the participants up to 82%.

Conclusion

The ULL-SPUT along with gender and BMI can be used as a practical strategy to detect the LBM and BMC of older adults in various settings. Such a strategy would facilitate timely managements (i.e. standard confirmation or appropriate interventions) in various settings.

Protocol for Forearm Pronosupination Strength Measuring in Different Postures: Reliability and Influence of Relevant Factors

IMPORTANCE

Despite the importance of pronosupination strength, which is key in daily activities, current evaluation protocols are disparate, and results differ regarding the influence of factors such as gender, age, limb dominance, or posture.

OBJECTIVE

To design a reliable device to measure pronation and supination torques in different forearm positions, considering the influence of gender, age, and limb dominance.

DESIGN

Reliability study with analysis of intrarater and interrater repeatability and examination of the influence of different factors on the strength of pronation and supination.

SETTING

Biomechanical analysis laboratory of the Instituto de Biomecánica de Valencia.

PARTICIPANTS

Convenience sample of 39 healthy male and female participants, ages 18 to 65 yr.

OUTCOMES AND MEASURES

Pronation strength and supination strength were studied in five forearm positions: 30° and 60° of supination, neutral rotation, and 30° and 60° of pronation. The influence of gender, age, and limb dominance was studied using repeated-measures analysis of variance. Intrarater and interrater reliabilities were studied in 17 participants, and the intraclass correlation coefficients (ICCs) were calculated from three measurement sessions.

RESULTS

Except for 60° of pronation, all ICCs ranged from .72 to .97. Gender, limb dominance, and posture significantly affected pronosupination strength (p < .05), with the highest supination strength at 60° of pronation and the highest pronation strength at 60° of supination.

CONCLUSIONS AND RELEVANCE

In using this reliable pronosupination torque assessment device and standardized protocol in the clinical setting, clinicians must consider the influence of gender, limb dominance, and forearm posture. What This Article Adds: The results of this study will allow occupational therapists to establish differences between patients' functionality in comparison with healthy individuals and to design recovery treatments and facilitate performance of manual tasks, considering which are the most advantageous positions to exert force. Furthermore, the developed device can be used to monitor the evolution of these torques in an objective and reliable manner.

A technology-enabled multi-disciplinary team-based care model for the management of Long COVID and other fatiguing illnesses within a federally qualified health center: protocol for a two-arm, single-blind, pragmatic, quality improvement professional cluster randomized controlled trial

BACKGROUND

The clinical burden of Long COVID, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and other post-infectious fatiguing illnesses (PIFI) is increasing. There is a critical need to advance understanding of the effectiveness and sustainability of innovative approaches to clinical care of patients having these conditions.

METHODS

We aim to assess the effectiveness of a Long COVID and Fatiguing Illness Recovery Program (LC&FIRP) in a two-arm, single-blind, pragmatic, quality improvement, professional cluster, randomized controlled trial in which 20 consenting clinicians across primary care clinics in a Federally Qualified Health Center system in San Diego, CA, will be randomized at a ratio of 1:1 to either participate in (1) weekly multi-disciplinary team-based case consultation and peer-to-peer sharing of emerging best practices (i.e., teleECHO (Extension for Community Healthcare Outcomes)) with monthly interactive webinars and quarterly short courses or (2) monthly interactive webinars and quarterly short courses alone (a control group); 856 patients will be assigned to participating clinicians (42 patients per clinician). Patient outcomes will be evaluated according to the study arm of their respective clinicians. Quantitative and qualitative outcomes will be measured at 3- and 6-months post-baseline for clinicians and every 3-months post assignment to a participating clinician for patients. The primary patient outcome is change in physical function measured using the Patient-Reported Outcomes Measurement Information System (PROMIS)-29. Analyses of differences in outcomes at both the patient and clinician levels will include a linear mixed model to compare change in outcomes from baseline to each post-baseline assessment between the randomized study arms. A concurrent prospective cohort study will compare the LC&FIRP patient population to the population enrolled in a university health system. Longitudinal data analysis approaches will allow us to examine differences in outcomes between cohorts.

DISCUSSION

We hypothesize that weekly teleECHO sessions with monthly interactive webinars and quarterly short courses will significantly improve clinician- and patient-level outcomes compared to the control group. This study will provide much needed evidence on the effectiveness of a technology-enabled multi-disciplinary team-based care model for the management of Long COVID, ME/CFS, and other PIFI within a federally qualified health center.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT05167227 . Registered on December 22, 2021.

Comparison of Grip Strength Measurements by Widely Used Three Dynamometers in Outpatients Aged 60 Years and Over

Grip strength (GS) is widely used in various fields such as sports, rehabilitation, and geriatrics to assess muscle strength, and to diagnose sarcopenia and frailty in older adults. There is a potential for measurement differences among different dynamometers available, and studies comparing GS measurements by variable tools have conflicting results. The two most frequently used dynamometers are the Jamar hydraulic (Jamar) and spring-type hand grip dynamometers, and Jamar has not been compared to Jamar PLUS+ Digital (Jamar+) dynamometer in older adults. So, we aimed to assess GS measurements with the Jamar as the reference standard against Jamar+, and spring-type Takei T.KK. 5401 (Takei) digital dynamometers. One hundred and ten outpatients aged >60 years were included. Inter-instrumental reliability was determined. The differences between dynamometers were evaluated by Bland-Altman plots and measurement error. The measurements with Jamar+, and Takei dynamometers were reliable and valid regarding the Jamar dynamometer. Takei and Jamar+ dynamometers overestimated GS over the Jamar dynamometer. Though the differences in the measured values might be disregarded in clinical practice, individuals defined to have low GS varied by the use of different dynamometers. Grip strength better be measured by the same dynamometer in serial measurements of older individuals.

Human Exteroception during Object Handling with an Upper Limb Exoskeleton

Upper limb exoskeletons may confer significant mechanical advantages across a range of tasks. The potential consequences of the exoskeleton upon the user's sensorimotor capacities however, remain poorly understood. The purpose of this study was to examine how the physical coupling of the user's arm to an upper limb exoskeleton influenced the perception of handheld objects. In the experimental protocol, participants were required to estimate the length of a series of bars held in their dominant right hand, in the absence of visual feedback. Their performance in conditions with an exoskeleton fixed to the forearm and upper arm was compared to conditions without the upper limb exoskeleton. Experiment 1 was designed to verify the effects of attaching an exoskeleton to the upper limb, with object handling limited to rotations of the wrist only. Experiment 2 was designed to verify the effects of the structure, and its mass, with combined movements of the wrist, elbow, and shoulder. Statistical analysis indicated that movements performed with the exoskeleton did not significantly affect perception of the handheld object in experiment 1 (BF₀₁ = 2.3) or experiment 2 (BF₀₁ = 4.3). These findings suggest that while the integration of an exoskeleton complexifies the architecture of the upper limb effector, this does not necessarily impede transmission of the mechanical information required for human exteroception.

A Musculoskeletal Model of the Hand and Wrist Capable of Simulating Functional Tasks

OBJECTIVE

The purpose of this work was to develop an open-source musculoskeletal model of the hand and wrist and to evaluate its performance during simulations of functional tasks.

METHODS

The current model was developed by adapting and expanding upon existing models. An optimal control theory framework that combines forward-dynamics simulations with a simulated-annealing optimization was used to simulate maximum grip and pinch force. Active and passive hand opening were simulated to evaluate coordinated kinematic hand movements.

RESULTS

The model's maximum grip force production matched experimental measures of grip force, force distribution amongst the digits, and displayed sensitivity to wrist flexion. Simulated lateral pinch strength replicated in vivo palmar pinch strength data. Additionally, predicted activations for 7 of 8 muscles fell within variability of EMG data during palmar pinch. The active and passive hand opening simulations predicted reasonable activations and demonstrated passive motion mimicking tenodesis, respectively.

CONCLUSION

This work advances simulation capabilities of hand and wrist models and provides a foundation for future work to build upon.

SIGNIFICANCE

This is the first open-source musculoskeletal model of the hand and wrist to be implemented during both functional kinetic and kinematic tasks. We provide a novel simulation framework to predict maximal grip and pinch force which can be used to evaluate how potential surgical and rehabilitation interventions influence these functional outcomes while requiring minimal experimental data.

Measures of Maximal Tactile Pressures during a Sustained Grasp Task Using a TactArray Device Have Satisfactory Reliability and Concurrent Validity in People with Stroke

Sensor-based devices can record pressure or force over time during grasping and therefore offer a more comprehensive approach to quantifying grip strength during sustained contractions. The objectives of this study were to investigate the reliability and concurrent validity of measures of maximal tactile pressures and forces during a sustained grasp task using a TactArray device in people with stroke. Participants with stroke (n = 11) performed three trials of sustained maximal grasp over 8 s. Both hands were tested in within- and between-day sessions, with and without vision. Measures of maximal tactile pressures and forces were measured for the complete (8 s) grasp duration and plateau phase (5 s). Tactile measures are reported using the highest value among three trials, the mean of two trials, and the mean of three trials. Reliability was determined using changes in mean, coefficients of variation, and intraclass correlation coefficients (ICCs). Pearson correlation coefficients were used to evaluate concurrent validity. This study found that measures of reliability assessed by changes in means were good, coefficients of variation were good to acceptable, and ICCs were very good for maximal tactile pressures using the average pressure of the mean of three trials over 8 s in the affected hand with and without vision for within-day sessions and without vision for between-day sessions. In the less affected hand, changes in mean were very good, coefficients of variations were acceptable, and ICCs were good to very good for maximal tactile pressures using the average pressure of the mean of three trials over 8 s and 5 s, respectively, in between-day sessions with and without vision. Maximal tactile pressures had moderate correlations with grip strength. The TactArray device demonstrates satisfactory reliability and concurrent validity for measures of maximal tactile pressures in people with stroke.

Age and Gender Differences in Anthropometric Characteristics and Motor Performance of 3 through 6 Young Kids Aged (Pilot Study)

BACKGROUND

It is crucial to evaluate children's motor coordination and strength to identify possible motor deficits on the right or left side of the body. However, whether a distinction exists in children aged 3-6 must be clarified. The goal of the current research was to investigate the differences in motor skills between preschool boys and girls, dominant and non-dominant hands or legs, in children of preschool age. (2) Methods: The present study was conducted on a sample of children (boys, n = 52; girls, n = 52; age range, 3-6 years). Three motor tests evaluated on both sides of the body served as the sample of factors used to measure athletic performance. Leg tapping (15 s), hand tapping (15 s), and a maximal hand grip strength (HGS) test kg. (3) Results: The study's findings show no statistically significant variations in preschool boys' and girls' motor skills. Preschool girls had better results in the right leg tapping than preschool boys t (98) = 2.08; p ≤ 0.04. We found a significant difference between genders aged 3-4, 4-5, and 5-6 years. No correlation was found between the girls' three variables and age. A small but significant positive correlation was found between dominant hand tapping and age r² (52) = 0.21; p ≤ 0.01, dominant leg tapping and age r² (52) = 0.20; p ≤ 0.01 and dominant HGS and age r² (52) = 0.17; p ≤ 0.01. No noticeable differences were identified when comparing the dominant side with the non-dominant side in each group. The results show that most children prefer to use their right hand and right leg as their dominant sides. (4) Conclusion: The authors of this study focus on the functional (frequency of movements) and dynamic (differences in muscle strength between body sides) elements of asymmetry. Future studies should examine the influence of morphology on performance with the dominant or non-dominant body side.

Association of handgrip strength with anthropometry of a Brazilian healthy adolescent sample

The importance of dynamometric and anthropometric information for industry is known; however, few studies have investigated the relationship between anthropometry and handgrip strength (HGS) in adolescents. The aim of the present study was to investigate the association of anthropometric variables with the level of HGS production in adolescents. Participants were 541 adolescents aged 12-16 years from a public school in the city of Rio de Janeiro. The behavior of the following variables was examined: the ability to generate HGS, age, total body mass, height and hand dimensions (hand width, hand span, hand length). The results showed an increase in the ability to generate HGS in adolescence and a significant difference between the genders from 13 years old, where boys generated higher HGS values. Correlations between HGS and total body mass and the hand width stood out in both genders, indicating a greater association.

Reliability and Validity of Shoulder and Handgrip Strength Testing

Purpose: This study aimed to estimate the intra- and inter-rater reliability of the JTECH computerized, wireless apparatus and its validity (compared to established devices) for measurements of maximal shoulder isometric strength and handgrip strength among healthy adults with no shoulder pathology. Methods: Twenty healthy young adults had shoulder strength tested with JTECH and Micro-FET2 hand-held dynamometers, and the handgrip strength was tested using JTECH and Jamar handgrip dynamometers. Assessments were performed by the same rater to determine intra-rater reliability and convergent validity, at least two days apart, while on a third visit, the other rater performed measures to determine inter-rater reliability. Results: The JTECH computerized, wireless devices demonstrated good to excellent intra-rater reliability (ICCs (2,1) = 0.78-0.97) and inter-rater reliability for strength measures (ICCs (2,1) = 0.76-0.95). The JTECH computerized device compared to the Micro-FET2 hand-held dynamometer showed substantial concurrent validity for shoulder flexion (R2 = 0.87), extension (R2 = 0.87), abduction (R2 = 0.88), and adduction (R2 = 0.85). Substantial concurrent validity was shown for the JTECH computerized device and Jamar handgrip dynamometers (R2 = 0.92). Conclusions: The JTECH computerized, wireless devices demonstrated high intra- and inter-rater reliability and substantial concurrent validity for shoulder isometric strength and handgrip strength in healthy adults.

Narrative Review of Sex Differences in Muscle Strength, Endurance, Activation, Size, Fiber Type, and Strength Training Participation Rates, Preferences, Motivations, Injuries, and Neuromuscular Adaptations

ABSTRACT

Nuzzo, JL. Narrative review of sex differences in muscle strength, endurance, activation, size, fiber type, and strength training participation rates, preferences, motivations, injuries, and neuromuscular adaptations. J Strength Cond Res 37(2): 494-536, 2023-Biological sex and its relation with exercise participation and sports performance continue to be discussed. Here, the purpose was to inform such discussions by summarizing the literature on sex differences in numerous strength training-related variables and outcomes-muscle strength and endurance, muscle mass and size, muscle fiber type, muscle twitch forces, and voluntary activation; strength training participation rates, motivations, preferences, and practices; and injuries and changes in muscle size and strength with strength training. Male subjects become notably stronger than female subjects around age 15 years. In adults, sex differences in strength are more pronounced in upper-body than lower-body muscles and in concentric than eccentric contractions. Greater male than female strength is not because of higher voluntary activation but to greater muscle mass and type II fiber areas. Men participate in strength training more frequently than women. Men are motivated more by challenge, competition, social recognition, and a desire to increase muscle size and strength. Men also have greater preference for competitive, high-intensity, and upper-body exercise. Women are motivated more by improved attractiveness, muscle "toning," and body mass management. Women have greater preference for supervised and lower-body exercise. Intrasexual competition, mate selection, and the drive for muscularity are likely fundamental causes of exercise behaviors in men and women. Men and women increase muscle size and strength after weeks of strength training, but women experience greater relative strength improvements depending on age and muscle group. Men exhibit higher strength training injury rates. No sex difference exists in strength loss and muscle soreness after muscle-damaging exercise.

The Assessment of Ankle Range-of-Motion and Its Relationship with Overall Muscle Strength in a Cross-Section of Soccer Players

Soccer (football) practice can induce a limitation of ankle range of motion (ROM) that is a possible risk factor for injury and other negative consequences over time. The main objective of this research was to investigate the effects of soccer practice on ankle ROM throughout the entire period of a sports career of soccer players (SP). Furthermore, the relationship between ankle ROM and muscle strength in SP of different ages was studied. A total of 204 SP (range 6.7−45.1 years) and 87 controls (range: 7.5−45.2 years) matched for age, body mass index (BMI), and gender, were assessed. Ankle ROM in both plantar flexion (APF) and dorsiflexion (ADF) in addition to handgrip strength (HGS) were evaluated using an inclinometer and the Jamar hydraulic hand dynamometer, respectively. The comparison between SP and control groups showed a significant reduction in ankle ROM of both APF (26.3 ± 7.2° vs. 32.6 ± 7.4°; d = −0.90; p < 0.001) and ADF (95.5 ± 15.6° vs. 105.5 ± 15.8°; d = −0.66; p < 0.001). In SP, the results of the ANOVAs test indicate that age had a significant effect on ADF (F = 4.352, p = 0.038, partial eta-squared (ηp2) = 0.015) but not on APF (F = 0.430, p = 0.746, ηp2 = 0.001). Moreover, considering only the SP, a weak inverse correlation between ADF and HGS group ADF was found (rs = −0.27; p < 0.001). Factors such as the non-linear trend of growth in young SP could hinder the definition of the relationship between ankle ROM, age, and muscle strength. However, the appropriate consideration of age and muscle strength could facilitate the management of ankle ROM in PF of different ages.

Evaluation of sarcopenia biomarkers in older patients undergoing major surgery for digestive cancer. SAXO prospective cohort study

BACKGROUND

The aim of the study was to prospectively evaluate different biomarkers to identify the most reliable for anticipating complications after major abdominal surgery for digestive cancer in older patients and compare their performance to the existing definition and screening algorithm of sarcopenia from EWGSOP.

METHODS

Ninety-five consecutive patients aged over 65 years who underwent elective surgery for digestive cancer were prospectively included in the SAXO study. Sarcopenia was defined according to EWGSOP criteria (four level from no sarcopenia to severe sarcopenia). Strength and physical performance were evaluated with the handgrip test (HGT) and gait speed test (GST), respectively. CT scan analysis was used to calculate the skeletal muscle index (SMI), intermuscular adipose tissue (IMAT), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). Measures were adjusted to body mass index (BMI). Complication grading was performed using the Clavien‒Dindo classification. A doubly robust estimator with multivariable regression was used to limit bias.

RESULTS

Sixteen patients presented with sarcopenia. Adjusted to BMI, sarcopenic patients had an increased IMAT^BMI (0.35 vs. 0.22; p = 0.003) and increased VAT^BMI (7.85 vs. 6.13; p = 0.048). In multivariable analysis, IMAT was an independent risk factor for minor and severe complications (OR = 1.298; 95% CI [1.031: 1.635] p = 0.027), while an increased SAT area was a protective factor (OR = 0.982; 95% CI [0.969: 0.995] p = 0.007). Twenty-two patients were obese (BMI ≥30 kg/m²). While no association was observed between obesity and sarcopenia (according to EWGSOP definition), obese patients had increased IMAT^BMI (0.31 vs. 0.23; p = 0.010) and VAT^BMI (8.40 vs. 6.49; p = 0.019). The combination of SAT, VAT and IMAT performed well to anticipate severe complication (AUC = 0.759) while AUC of EWGSOP 2010 and 2019 algorithm were 0.660 and 0.519, respectively.

DISCUSSION

Non-invasive and imaging related measures of IMAT, SAT and VAT seems to be valuable tools to refine risk-assessment of older patients in surgery and specially to detect myosteatosis in obese ones.

Musculoskeletal Pain in Family Caregivers: Does a Therapeutic Physical Program in Primary Care Work? A Randomized Controlled Trial

Background: Family caregivers play a crucial role in the overall healthcare system and in our society. The elderly population is significantly increasing, which creates a high demand for family caregivers. Few studies have investigated the impact of caregiving on musculoskeletal pain or proposed an active approach for dealing with it. Objectives: To determine and characterize musculoskeletal pain in female family caregivers (FFCs) and assess the effects of adding a therapeutic exercise program to a family caregiver care program (FCCP) on the quality of life, physical conditions, and psychological well-being of FFCs. Methods: A multicenter randomized controlled clinical trial was conducted with 68 FFCs recruited in two public healthcare areas. The intervention and control groups received the same conventional FCCP for 6 h across 4 sessions. The intervention group received an additional 36 sessions of physical therapeutic exercise (PTE) program over 12 weeks. Results: All caregivers reported having pain in particular locations. Lower back pain and neck pain were the locations most frequently cited, with a prevalence of 69.4% and 56.7%, respectively. In total, 80% of participants presented moderate pain intensity. The intervention group showed a significant decrease in the intensity of the pain (p < 0.001), as well as in anxiety, depression, subjective burden perception (p < 0.01), and quality-of-life variables, including MCS (mental component summary) (p < 0.05) and PCS (physical component summary) (p < 0.001). Conclusions: A PTE program improved the musculoskeletal pain of FFCs in a clinically relevant way. The caregivers who improved the most were those who initially presented the most intense pain, had the greatest levels of disability, and had the lowest quality of life.

Validity and reliability of the measurement instrument of the nursing outcome health-related Physical Fitness (2004), proposed and transculturally adapted to the Spanish context

BACKGROUND

Presently, physical inactivity is the main public health problem in many countries worldwide. Physical activity promotes the maintenance or improvement of one's physical condition. Physical fitness has been established as the main biological marker of the state of health of an individual, and therefore, there is a clear need to measure health-related physical fitness through the use of a reliable and valid instrument. This study is a continuation of the transcultural adaptation process and a new proposal of the nursing outcome Physical Fitness (2004), found in the 5^th Edition of the Nursing Outcomes Classification. The objective of this study was to examine the validity and reliability of the nursing outcome Health-Related Physical Fitness survey, proposed and transculturally adapted to the Spanish context.

METHODS

An instrumental study to validate the nursing outcome Physical Fitness (2004), from the 5^th Edition of the Nursing Outcome Classification was carried out. It took place between the months of May, 2016 to May, 2017. On the first stage, the instrument proposed Health-Related Physical Fitness survey was administered to 160 adults who used the Health Services of Murcia, Spain by three independent evaluators. After 4 weeks, it was administered again to 33 participants to calculate the intra-rater reliability. Lastly, the SF-12v2 Health Survey was administered to obtain external evidence of validity.

RESULTS

The inter-rater reliability of the nursing outcome proposed obtained high values (between 0.91-0.99) in the evaluations performed by the three evaluators. As for the intra-rater reliability, high values were obtained (0.94-1), except for the item "balance", which was moderate (0.56). Lastly, a positive and statistically significant correlation (p < 0.05) was obtained between the Physical Component Summary, and the dimensions Physical Functioning and General Health from the SF-12v2 Health Survey, and the global score of the Health-Related Physical Fitness proposed instrument.

CONCLUSIONS

The validity and reliability results of the nursing outcome Health-Related Physical Fitness survey, proposed and transculturally adapted to the Spanish context, were adequate for its use by nurses with adults who use the Health Services of Murcia. However, this instrument must be analyzed with more diverse samples of health services users.

Muscle Strength Reference Values and Correlation with Appendicular Muscle Mass in Mexican Children and Adolescents

Strength and muscle mass are important determinants of health status, and reference values for pediatric populations from every country or geographic region are needed. The aim of this study was to develop age- and sex-specific reference values of muscle strength and evaluate the correlation between muscle strength and appendicular lean mass in Mexican children and adolescents. A cross-sectional study was conducted in 1111 healthy subjects ages 5 to 19 years of age participating in the "Body Composition Reference Values in Mexican Children and Adolescents" study. Smoothed reference values for the 1, 3, 5, 15, 25, 50, 75, 85, 95, 97, and 99 percentiles of muscle strength for upper and lower limbs were developed based on age and sex using Jamar® and Microfet2® dynamometers. Mean values were derived using the Generalized Additive Models for Location, Scale and Shape (GAMLSS), and lean mass was determined using dual-energy X-ray absorptiometry. Highly positive correlations of muscle strength with lean mass in upper limbs were found r-values 0.87-0.92 for boys and r = 0.80-0.86 for girls. High and moderate positive correlations for lower limbs were also noted for upper limbs: r = 0.74-0.86 for boys and r = 0.67-0.82 for girls. The reference values for appendicular muscle strength established in this study demonstrated a high and positive correlation between appendicular mass and muscle strength. These data will be useful when evaluating conditions and diseases affecting muscle or sports.

Predicting handgrip power of young adult population among major ethnic groups of Sabah: a multivariate analysis

Background

Handgrip power is an essential indicator of health, vital for grasping or gripping sports, and crucial for providing information related to work capacity. The present study investigated any linear relationship of handgrip power with hand anthropometric variables (hand length, handbreadth, middle finger length, second inter-crease length of the middle finger, and hand span), gender, and ethnicity in young adults of Sabah.

Methods

In this cross-sectional study (from January 2020 to December 2021), the adult Sabahan population (18-25 years) was stratified into four ethnicities (KadazanDusun, Bajau, Malay, and Chinese) and was further stratified as males and females. Then, 46 subjects were randomly selected from each gender, and the ethnic group met the intended sample size. The hand dimensions were measured using a digital calliper, and the handgrip power was measured using a portable dynamometer. The relationship between the response variable and explanatory variables was analyzed at first through simple linear regression and then multiple linear regression. R², adjusted R², and standard errors of the estimates were used to compare different models. Statistical analyses were performed using IBM SPSS Statistics 27 and StatCrunch.

Results

The study found a linear relationship between gender, height, hand length, handbreadth, hand span, middle finger length, and second inter-crease length of both hands with the corresponding hand’s grip power. The highest percentage (68% and 67%) of handgrip variability was demonstrated by the model predicting handgrip power for right-handed subjects, followed by the general models without stratifying based on hand dominance which was able to explain 63% and 64% of the variability of handgrip power. The study proposes the models for predicted right (RHGP) and left handgrip power (LHGP) of 18 to 25 years old adults from major ethnic groups of Sabah RHGP = − 18.972 − 8.704 Gender + 7.043 Right hand breadth and LHGP = − 11.621 − 9.389 Gender + 5.861 Left hand breadth respectively.

Conclusion

The predicted handgrip power would be a key to selecting a better player or a better worker or assessing the prognosis of a disease or the wellbeing of a person. The study can be further expanded to all ethnicities and ages of people of Sabah or even Malaysia.

Rehabilitation of Post-COVID-19 Musculoskeletal Sequelae in Geriatric Patients: A Case Series Study

The musculoskeletal system is affected in over 40% of patients with Coronavirus disease 2019 (COVID-19). There is an increased need for post-acute rehabilitation after COVID-19, especially in elderly people with underlying health problems. The aim of this study was to evaluate the benefits of an early and goal-orientated rehabilitation program using combined approaches, robotic medical devices together with other rehabilitation techniques and therapies, in elderly people after acute COVID-19. Ninety-one patients (62.64 ± 14.21 years) previously diagnosed with severe SARS-CoV-2 infection were admitted to the Medical Rehabilitation Clinical Hospital Baile Felix, Romania, for medical rehabilitation, but only six patients (85.33 ± 3.07 years) met the inclusion criteria and participated in the study. The rehabilitation treatment was complex, performed over 4 weeks, and included combined approaches: exercise therapy, robotic gait training, occupational therapy, and massages. Activity and participation evaluation were performed using the Barthel Index and Functional Independence Measure for activities of daily living (ADLs). Assessments were performed at admission and discharge from the rehabilitation clinic. Lokomat patients' reports revealed that the patients had improved motor control (with one exception). The measurement of functional ability revealed an improvement in most cases. This study presents some of the first data on outcomes of COVID-19 patients' musculoskeletal rehabilitation in our country. Early complex medical rehabilitation improved functional independence and autonomy in ADLs in very old patients, post-COVID-19.

Test-Retest Reliability and Sensitivity of Common Strength and Power Tests over a Period of 9 Weeks

This study evaluated the reliability and sensitivity of a set of different common strength and power tests in a healthy adult population in a span of 9 weeks. Seventeen subjects (24.2 ± 2.2 years, 1.75 ± 0.10 m, 68.6 ± 14.2 kg, seven women) participated in the study. We tested countermovement jumps, reactive hops, and the maximal voluntary contraction (MVC) of handgrip and isometric knee extension. The tests were conducted in three separate sessions across a nine-week period, with one week between the first two sessions and eight weeks between the second and the third. Reliability and sensitivity statistics for each test were calculated for both the average of three trials and the best result during each session. The MVC of isometric knee extension and handgrip, as well as the countermovement jump test, demonstrated very high reliability and sensitivity over the nine-week period. The peak force of the reactive hops demonstrated high reliability but high sensitivity only for the average but not for the best result. The average contact time of reactive hops was neither a sensitive nor reliable measurement. In conclusion, isometric maximal knee extension and handgrip tests, as well as countermovement jumps and peak force of reactive hops, can be used as reliable and sensitive measurements of isometric and reactive strength and power over time periods of up to eight weeks. We recommend the use of the average results of three trials instead of the best performance value for longitudinal studies, as this procedure produces more consistent results and a lower measurement error.

Handgrip strength and its correlation with anthropometric determinants and hand dimensions in children aged 6-12 years: A cross-sectional study

BACKGROUND

Handgrip strength is considered an important interpreter of general health, and hand functions in children. It is mainly influenced by anthropometric determinants and hand dimensions.

OBJECTIVE

To assess the handgrip strength and their association with anthropometric determinants, hand circumference, hand span, and hand length among school children in both the dominant and non-dominant hand.

METHODS

Anthropometric measurements, hand circumference, hand span, hand length, and grip strength measurements were obtained from 133 school children of both genders aged 6-12 years. A Jamar hand-held dynamometer was used to measure handgrip strength and the hand dimensions with a tape measure in cm.

RESULTS

Significant differences were found between the handgrip strength among boys and girls. The dominant hand was found to be sturdier than the non-dominant hand in both genders. We also found a significant correlation of anthropometric determinants and hand dimensions with handgrip strength. Age, BMI, hand circumference, hand span, and hand length had a strong correlation with grip strength (p < 0.01).

CONCLUSIONS

The study revealed the reference values and concluded its correlations with hand dimensions among school children aged 6-12 years and this information can serve as a manual for interpretation of handgrip strength measurements in children.

Impacts of Astaxanthin Supplementation on Walking Capacity by Reducing Oxidative Stress in Nursing Home Residents

Oxidative stress is associated with deterioration of endurance and muscle strength, which are mostly accompanied by aging. Astaxanthin supplement has excellent antioxidant activity without any pro-oxidative properties. In this study, we investigated how astaxanthin supplementation affects walking endurance and muscle strength in nursing home residents. Healthy elderly individuals (age: 67 to 94) were divided into two groups: 13 subjects received a daily dose of 24 mg of astaxanthin for 16 weeks (astaxanthin group) and 11 subjects received a placebo (placebo group). These subjects were compared using body component measurements, serum d-ROM levels, the distance of 6-min walking, blood lactate levels after the 6-min walking test, and muscle strength. After supplementation, the levels of d-ROMs and blood lactate after the 6-min walking test in the astaxanthin group significantly decreased compared with the placebo group (p < 0.05). Additionally, the walking distance was significantly higher in the astaxanthin group than in the placebo group (p < 0.05), despite a significant reduction in lactate levels after 6-MWT (p < 0.05). However, no significant intergroup differences were observed in muscle mass and strength. Astaxanthin supplement for 16 weeks is effective to increase the endurance capacity of the elderly. Astaxanthin supplement suppresses d-ROMs at rest and lactic acid production after the 6-min walk test. In contrast, astaxanthin supplement did not show significant intergroup differences in the muscle mass and strength. Therefore, the effect was most likely accompanied by an increase in endurance instead of an increase in muscle strength.

Measurement of hand grip strength: A cross-sectional study of two dynamometry devices

Background

Grip strength has been identified as an important indicator of health status and predictor of clinical outcomes. The gold standard for measuring grip strength is the JAMAR® Hydraulic Hand Dynamometer. Less expensive dynamometers are available but have not been validated within a hospital setting.

Objectives

To validate the Camry Digital Handgrip Dynamometer (Model EH101) against the validated JAMAR® Dynamometer (Model J00105) in a hospital population.

Methods

A cross-sectional observational study with a randomised single-blind cross-over component was conducted on consenting adult patients admitted to general hospital wards. The best of three measurements taken using the dominant hand was used for analysis.

Results

Fifty-one participants (median [interquartile range] age 42 [30–58] years; n = 27 [52.9%] female) were included. The mean difference between the Jamar® and Camry measurements was 1.9 kg ± 3.6 kg (t-value 0.9; p = 0.4). There was a strong positive correlation between the Jamar® and the Camry devices (R = 0.94; r² = 0.88; p < 0.0001). Excellent agreement was found between Jamar® and Camry measurements (interclass correlational coefficient 0.97, 95% CI 0.94–0.99, p < 0.0001). Hand dominance significantly affected the agreement between devices (p = 0.002).

Conclusions

The Camry Digital Handgrip Dynamometer is a valid tool for assessing grip strength in hospitalised adult patients.

Clinical implications

The Camry Digital Handgrip Dynamometer could be used as an inexpensive tool to measure grip strength.

Cohort profile: 'Biomarkers of Personalised Medicine' (BioPersMed): a single-centre prospective observational cohort study in Graz/Austria to evaluate novel biomarkers in cardiovascular and metabolic diseases

PURPOSE

Accumulating evidence points towards a close relationship between cardiovascular, endocrine and metabolic diseases. The BioPersMed Study (Biomarkers of Personalised Medicine) is a single-centre prospective observational cohort study with repetitive examination of participants in 2-year intervals. The aim is to evaluate the predictive impact of various traditional and novel biomarkers of cardiovascular, endocrine and metabolic pathways in asymptomatic individuals at risk for cardiovascular and/or metabolic disease.

PARTICIPANTS

Between 2010 and 2016, we recruited 1022 regional individuals into the study. Subjects aged 45 years or older presenting with at least one traditional cardiovascular risk factor or manifest type 2 diabetes mellitus (T2DM) were enrolled. The mean age of the participants was 57±8 years, 55% were female, 18% had T2DM, 33% suffered from arterial hypertension, 15% were smokers, 42% had hyperlipidaemia, and only 26% were at low cardiovascular risk according to the Framingham 'Systematic COronary Risk Evaluation'.

FINDINGS TO DATE

Study procedures during screening and follow-up visits included a physical examination and comprehensive cardiovascular, endocrine, metabolic, ocular and laboratory workup with biobanking of blood and urine samples. The variety of assessed biomarkers allows a full phenotyping of individuals at cardiovascular and metabolic risk. Preliminary data from the cohort and relevant biomarker analyses were already used as control population for genomic studies in local and international research cooperation.

FUTURE PLANS

Participants will undergo comprehensive cardiovascular, endocrine and metabolic examinations for the next decades and clinical outcomes will be adjudicated prospectively.

GripAble: An accurate, sensitive and robust digital device for measuring grip strength

Introduction

Grip strength is a reliable biomarker of overall health and physiological well-being. It is widely used in clinical practice as an outcome measure. This paper demonstrates the measurement characteristics of GripAble, a wireless mobile handgrip device that measures grip force both isometrically and elastically-resisted for assessment and training of hand function.

Methods

A series of bench tests were performed to evaluate GripAble's grip force measurement accuracy and sensitivity. Measurement robustness was evaluated through repeated drop tests interwoven with error verification test phases.

Results

GripAble's absolute measurement error at the central position was under 0.81 and 1.67 kg (95^th percentiles; N = 47) when measuring elastically and isometrically, respectively, providing similar or better accuracy than the industry-standard Jamar device. Sensitivity was measured as 0.062 ± 0.015 kg (mean ± std; 95^th percentiles: [0.036, 0.089] kg; N = 47), independent of the applied force. There was no significant performance degradation following impact from 30 drops from a height >1.5 m.

Conclusion

GripAble is an accurate and reliable grip strength dynamometer. It is highly sensitive and robust, which in combination with other novel features (e.g. portability, telerehabilitation and digital data tracking) enable broad applicability in a range of clinical caseloads and environments.

A Review of Handgrip Strength and its Role as a Herald of Health

Measurement of grip strength using a handheld dynamometer is frequently performed as part of an orthopedic upper extremity examination. We review the technique of grip strength measurement and evaluation of the possible submaximal effort. What constitutes normal grip strength in one part of the world is not necessarily normal elsewhere. Additionally, there is considerable evidence, most of which is outside the orthopedic literature, that diminished grip strength is a proxy for poor health and a predictor of increased mortality.

Modernising grip dynamometry: Inter-instrument reliability between GripAble and Jamar

INTRODUCTION

Maximum grip strength (MGS) is a reliable biomarker of overall health and physiological well-being. Therefore, an accurate and reliable measurement device is vital for ensuring the validity of the MGS assessment. This paper presents GripAble, a mobile hand grip device for the assessment of MGS. GripAble's performance was evaluated using an inter-instrument reliability test against the widely used Jamar PLUS+ dynamometer.

METHODS

MGS data from sixty-three participants (N = 63, median (IQR) age = 29.0 (29.5) years, 33 M/30 F) from both hands using GripAble and Jamar PLUS+ were collected and compared. Intraclass correlation (ICC), regression, and Bland and Altman analysis were performed to evaluate the inter-instrument reliability and relationship in MGS measurements between GripAble and Jamar PLUS+ .

RESULTS

GripAble demonstrates good-to-excellent inter-instrument reliability to the Jamar PLUS+ with ICC3,1 = 0.906 (95% CI [0.87-0.94]). GripAble's MGS measurement is equivalent to 69% (95% CI [0.67-0.71]%) of Jamar PLUS+'s measurement. There is a proportional difference in mean MGS between the two devices, with the difference in MGS between GripAble and Jamar PLUS+ increasing with MGS.

CONCLUSION

The GripAble is a reliable tool for measuring grip strength. However, the MGS readings from GripAble and Jamar PLUS+ should not be interchanged for serial measurements of the same patient, nor be translated directly from one device to the other. A new normative MGS data using GripAble will be collected and accessed through the software for immediate comparison to age and gender-matched subpopulations.

Pediatric Co-Norms for Finger Tapping, Grip Strength, and Grooved Pegboard in a Community Sample

OBJECTIVE

Motor tests, including Finger-Tapping Test, Grooved Pegboard Test, and Grip Strength Test, are frequently used by neuropsychologists when assessing pediatric populations. Many of the norms available for these measures are outdated, have not been co-normed, and have samples with limited diversity. This study aims to provide updated, co-norms for three commonly used motor tasks with a diverse population.

METHOD

Participants (n = 476; age range 6-14) were recruited from community settings to complete each of the three motor tests.

RESULTS

Results demonstrate generally improved performance across ages with no significant difference between performance of males and females on the Grooved Pegboard Test or the Finger Tapping Test. The only significant findings were on the Grip Strength Test where 12-14-year-old boys demonstrated stronger performance on the dominant hand.

CONCLUSION

This study provides updated and co-normed data on frequently used motor tasks with a diverse pediatric sample, which are useful for clinicians.

Does a relationship between handgrip strength and coincidence anticipation timing exist among young adults: a pilot study

The purpose of this investigation was to observe whether a strong to moderate relationship exists between maximal handgrip strength best score and best coincidence anticipation timing (CAT) score in young adults. Handgrip strength has demonstrated a strong relationship with high levels of activities of daily living (ADLs) and reduced injury potential. A one-shot case-study design was selected for this investigation. Twenty-three females and one male volunteered for this investigation (age 22.29 ± 4.71 years, height 63.78 ± 6.22 cm, mass 56.66 ± 8.25 kg) from a local higher education institution. Participants (n = 24) utilized the Bassin anticipation timing device (Lafayette Instruments, USA) and a Camry digital hand dynamometer (Model EH101, Camry LLC, El Monte, CA, USA) during the same time and recorded all scores. The Pearson correlation coefficient (r = -0.413; p = 0.04) indicated a medium effect relationship between best maximal handgrip strength and best CAT score.

Intrarater reliability test of the ISOmetric power device-A new instrument for assessment of isometric force in six directions of wrist motion

STUDY DESIGN

Descriptive reliability study.

INTRODUCTION

A well-functioning wrist requires sufficient range of motion accompanied by adequate strength in every movement and direction-factors that are not regularly measured simultaneously in patients with wrist problems today. The ISOmetric Power device (ISOP) is a new instrument that measures isometric wrist force in all six directions of motion, but its intrarater reliability in a healthy population has not yet been evaluated.

PURPOSE OF THE STUDY

The purpose of this study was to perform an intrarater reliability test of the ISOP in healthy participants.

METHODS

Thirty-two healthy study participants (16 women/16 men; mean age 38.3 years; SD 6.5) were included. With a standardized testing protocol, the three planes of wrist motion- wrist flexion/extension, radial/ulnar deviation, pro/supination-were measured at one time interval (T1) and repeated after one week (T2). The results were analyzed using the intraclass correlation coefficient (ICC). A paired-samples t-test was also performed to determine if a statistically significant difference (P < .05) existed between the first and the second test values. Measurements with Jamar Dynamometer were performed at both time intervals, for internal control of measurement intrarater reliability.

RESULTS

Excellent correlations (ICC: 0.90-0.99) were found for all test-retests performed. The lowest value (ICC: 0.90) was seen for supination and the highest value (ICC: 0.99) for flexion of the left hand. No statistically significant differences were found in any of the pairs (P > .05) in terms of test-re-test, which additionally strengthen the correlation between the first and second test values.

DISCUSSION

Contrary to the Jamar Dynamometer, the ISOP is not designed for measuring grip strength, but for assessing the isometric muscle force in flexion, extension, pronation, supination, and radial and ulnar deviation. A systematic review has reported a moderate to strong correlation between isometric strength and dynamic performances. Thus, the ISOP is a more complete and applicable instrument for evaluating the functional strength in different directions in the upper extremity.

CONCLUSIONS

The ISOmetric Power device shows excellent intrarater reliability and is proposed to be a possible valuable wrist strength assessment tool to aid in both diagnostics and outcome measures of wrist and upper extremity disorders.

Understanding of sarcopenia: from definition to therapeutic strategies

Sarcopenia refers to the gradual loss of skeletal muscle mass and function along with aging and is a social burden due to growing healthcare cost associated with a super-aging society. Therefore, researchers have established guidelines and tests to diagnose sarcopenia. Several studies have been conducted actively to reveal the cause of sarcopenia and find an economic therapy to improve the quality of life in elderly individuals. Sarcopenia is caused by multiple factors such as reduced regenerative capacity, imbalance in protein turnover, alteration of fat and fibrotic composition in muscle, increased reactive oxygen species, dysfunction of mitochondria and increased inflammation. Based on these mechanisms, nonpharmacological and pharmacological strategies have been developed to prevent and treat sarcopenia. Although several studies are currently in progress, no treatment is available yet. This review presents the definition of sarcopenia and summarizes recent understanding on the detailed mechanisms, diagnostic criteria, and strategies for prevention and treatment.