Abstract
Grip, Key Pinch (KP), 3 Point Pinch (3PP) and 2 Point Pinch (2PP) strengths were measured twice weekly in 32 women with primary osteoarthritis of the hand (POAH) and 25 healthy women. Reproducibility was assessed by standard error of measurement (SEM) and the coefficient of variation (CV). Cutoff values for significant improvement or deterioration were determined and expressed, respectively, as either the smallest detectable difference (SDD) or critical difference (CD). The SDD and CD of grip and pinch strengths were higher in POAH patients than in the healthy group. Among the pinch tests the 2PP findings were least reproducible. The relatively high SDD and CD scores indicate that improvement may be detected only in patients with moderate to severe weakness of grip and pinch. Furthermore, in POAH patients, diagnosing strength changes using the 2PP test is invalid due to low reproducibility.
Highlights
Osteoarthritis (OA) is the most common joint disease in women aged 65 and beyond
The use of absolute parameters such as the standard error of measurement (SEM) or the coefficient of variation of the standard deviation (CVp) lead to determination of cutoff scores which correspond to the amount of change that is beyond the natural individual variation of the criterion parameter
Grip measurement related to the second position of the dynamometer and was performed with the elbow at about 90° according to the American Society of Hand Therapists (ASHT) recommendations [16]
Summary
Osteoarthritis (OA) is the most common joint disease in women aged 65 and beyond. It is characterized by weakness, pain and reduced functional ability [1, 2]. Reproducibility of hand strength measurements was reported in various studies [4,5,6,7,8,9,10,11,12,13,14] Those measurements were largely based on the use of the so-called relative parameters such as Pearson's r or intra-class correlation coefficients (ICC). These parameters do not provide error margins. The use of absolute parameters such as the standard error of measurement (SEM) or the coefficient of variation of the standard deviation (CVp) lead to determination of cutoff scores which correspond to the amount of change that is beyond the natural individual variation of the criterion parameter. In order to set up such cutoffs at the individual subject or patient level, the SEM-based smallest detectable difference (SDD) [7, 8] or the CVp-based critical difference (CD) [9, 10] have been used
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