Abstract
ABSTRACTBackgroundMuscle strength is usually measured in individuals with stroke with Portable dynamometers (gold standard). However, no studies have investigated the reliability, the standard error of measurement (SEM) and the minimal detectable difference (MDD95%) of the dynamometry for the measurement of hand grip, pinch grip and trunk strength in subjects with subacute stroke.Objective1) To investigate the intra and inter-rater reliability, the SEM and the MDD95% of the portable dynamometers for the measurement of grip, pinch and trunk strength in subjects with subacute stroke, and 2) to verify whether the use of different number of trials (first trial and the average of the first two and three trials) affected the results.Method32 subjects with subacute stroke (time since stroke onset: 3.6 months, SD=0.66 months) were evaluated. Hand grip, 3 pinch grips (i.e. pulp-to-pulp/palmar/lateral) and 4 trunk muscles (i.e. flexors, extensors, lateral flexors and rotators) strength were bilaterally assessed (except trunk flexors/extensors) with portable dynamometry by two independent examiners over two sessions (1-2 weeks apart). One-way ANOVAs and intraclass correlation coefficients (ICC2,k) were used for analysis (α=0.05). SEM and MDD95% were also calculated.ResultsFor all muscular groups and sources of outcome values, including one trial, after familiarization, similar results were found (0.01≤F≤0.08; 0.92≤p≤0.99) with significant and adequate values of intra-rater (0.64≤ICC≤0.99; 0.23≤95%CI≤0.99) and inter-rater (0.66≤ICC≤0.99; 0.25≤95%CI≤0.99) reliability. SEM and MDD95% were considered low (0.39≤EPM≤2.21 Kg; 0.96≤MMD95%≤6.12 Kg) for all outcome scores.ConclusionOnly one trial, following familiarization, demonstrated adequate intra-rater and inter-rater reliability of the portable dynamometers for the measurement of hand grip, pinch grip and trunk strength in subjects with subacute stroke.
Highlights
Hemiparesis, a disability arising from a stroke, with muscle weakness predominant in the hemi‐body contralateral to the cerebral lesion, is observed in approximately 77% of individuals with stroke[1,2,3,4]
Portable dynamometers are considered a valid instrument for measuring isometric muscular strength - they are easy to use, they provide objective measurements, they are sensitive for detecting changes in muscle strength[10,12], and they provide suitable
The intra-rater and inter-rater reliability of portable dynamometers in the measurement of hand grip, pinch grip, and trunk strength was recently investigated in individuals in the chronic phase of stroke[13], and demonstrated adequate results, with Intraclass Correlation Coefficients (ICC) varying from moderate to very high[14] (0.58≤ICC≤0.98)
Summary
Hemiparesis, a disability arising from a stroke, with muscle weakness predominant in the hemi‐body contralateral to the cerebral lesion, is observed in approximately 77% of individuals with stroke[1,2,3,4]. The measurement of muscle strength in post stroke individuals is commonly performed[9] in different phases of the disease[10,11]. The intra-rater and inter-rater reliability of portable dynamometers in the measurement of hand grip, pinch grip, and trunk strength was recently investigated in individuals in the chronic phase of stroke[13], and demonstrated adequate results, with Intraclass Correlation Coefficients (ICC) varying from moderate to very high[14] (0.58≤ICC≤0.98). For portable dynamometers to be employed in the subacute phase of stroke, it is necessary to assess measurement properties of these instruments in this population. According to a recent systematic review, no study has investigated the measurement properties of portable dynamometers to assess hand grip, pinch grip, and trunk strength in the subacute phase of stroke[20]
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