Handgrip Strength In Patients Research Articles

Reliability, validity and usability of the K-force® grip dynamometer to evaluate handgrip-strength in patients with intensive care unit-acquired weakness

Objective Handgrip dynamometry is recognised as a method for evaluating volitional muscle strength in the intensive care, but conventional handgrip dynamometers cannot accurately measure grip strength in very weak patients. The aim of this study was to determine the reliability, validity and usability of the K-force® grip in patients with intensive care unit-acquired weakness. Design Evaluation of measurement properties of the K-force® grip. Setting Two Intensive Care Units in The Netherlands. Participants Patients diagnosed with intensive care unit-acquired weakness according to a Medical Research Council sum score <48. Intervention & Main measures Intra- and inter-rater reliability of the K-force® grip were assessed using the intraclass correlation coefficient. Concurrent validity was examined using calibration weights. The usability was evaluated with the System Usability Scale. Results Intra-rater reliability showed an intraclass correlation coefficient of 0.987 for the dominant hand and 0.972 for the non-dominant hand. Inter-rater reliability showed coefficients of 0.944 for the dominant hand and 0.942 for the non-dominant hand. There was a perfect correlation ( r = 1) between the K-force® grip and the calibration weights. The usability of the K-force® grip was rated excellent by 11 healthcare professionals with a System Usability Scale score of 86. Conclusions The K-force® grip is a promising new tool for the evaluation of muscle strength in intensive care unit-acquired weakness patients who are too weak to use conventional hand dynamometers.

Association of physical inactivity and handgrip strength with non-tuberculous mycobacterial pulmonary disease.

<sec><title>BACKGROUND</title>Little is known about the level of physical activity (PA) among patients with non-tuberculous mycobacterial pulmonary disease (NTM-PD), the relationship between PA levels and NTM-PD, and the relationship between handgrip strength and NTM-PD.</sec><sec><title>METHODS</title>We conducted a case-control study comparing the PA levels and handgrip strength of patients with NTM-PD and controls. Patients with NTM-PD were prospectively enrolled at Severance Hospital, Seoul, whereas controls were selected at a 1:2 propensity score matching from the Korea National Health and Nutrition Examination Survey conducted between 2014 and 2019. Multivariate logistic regression analysis was conducted to evaluate these relationships.</sec><sec><title>RESULTS</title>The total PA level in the NTM-PD group was lower than that in the control group (120.0 vs. 560.0 MET-min/week, P < 0.001). Physical inactivity was significantly associated with both NTM-PD (aOR 2.87, 95% CI 1.73-4.75) and severity of NTM-PD (aOR 3.82, 95% CI 1.61-9.05; cavity ≥1). Low handgrip strength was found to be associated with NTM-PD (aOR 2.14, 95% CI 1.14-4.02), but no significant association was observed with the severity of NTM-PD.</sec><sec><title>CONCLUSIONS</title>Physical inactivity was associated with both NTM-PD and NTM-PD severity, whereas low handgrip strength was associated with NTM-PD.</sec>.

Investigation of sensory and motor functions of wrist in patients with rheumatoid arthritis

BackgroundRheumatoid arthritis (RA) is a systemic and autoimmune disease that affects many tissues and organs in the body, especially the synovial joint and periarticular structures. One of the most affected joints is the hand joints, and there is also involvement in the wrist joint. ObjectivesThe purpose of this study was to assess the sensory and motor functions of the wrist with a gold standard method and to determine the relationship between the motor and sensory functions of the wrist and wrist-related pain/disability level and hand grip strength in patients with RA. MethodFlexor and extensor muscle strength and joint position sense of the wrist were evaluated using isokinetic dynamometer, hand grip strength was measured using dynamometer, and wrist related pain and disability was assessed by Patient Rated Wrist Evaluation (PRWE) questionnaire. ResultsThirty-one patients with RA and 31 healthy controls were included in the study. Control group had better results regarding wrist flexor and extensor muscle strength and wrist joint position sense than RA patients for both hands/wrists. A positive and strong correlation and a negative and weak correlation were found between muscle strength and joint position sense of the wrist and hand grip strength, respectively. ConclusionsCompared to healthy subjects, RA patients showed wrist-related sensorimotor deficits. Therefore, evaluation of the wrist should not be ignored in the examination of patients with RA. In addition, when planning the treatment program of the patients, not only hand exercises but also exercises involving the wrist should be taken into consideration.

Risk of Sarcopenia Identified by Sarc-Calf, Nutritional Status and Hand Grip Strength in Patients with Hematological Cancer.

Background: Hematological cancer patients are prone to the development of sarcopenia and impaired nutritional and functional status. SARC-CalF is a screening tool for the risk of sarcopenia that has shown good results in this population. This study aimed to identify the risk of sarcopenia by SARC-CalF and to verify its association with nutritional status and Hand Grip Strength (HGS) in patients with hematological cancer. Materials and Methods: Adult patients, of both sexes, with hematological cancer, and in outpatient care participated in the study. We measured the Hand Grip Strength of the Dominant Hand (HGSD) and the Adductor Pollicis Muscle Thickness of the Dominant Hand (APMTD). Moreover, we applied the Patient-Generated Subjective Global Assessment (PG-SGA) and SARC-CalF. Data were analyzed with SPSS® software, 22.0, with a significance level of 5.0%. Results: Fifty-one patients aged an average of 60.4 ± 15.1 years were evaluated. Of those, 58.8% were elderly, 51% female, and 80.4% declared themselves non-white. The predominant diagnosis was Mature B Lymphoid Cell Neoplasia (37.7%), and 60.8% of the patients had a diagnosis time of ≤ 3 years. PG-SGA revealed that 35.3% of the patients were malnourished; APMTD and HGSD revealed that 60.8% and 25.5% had reduced muscle strength, respectively. SARC-CalF exposed that 39.2% of the patients were at risk for sarcopenia. Significant associations were found between SARC-CalF and diagnosis time ≤ 3 years (p = 0.039), PG-SGA (p = 0.020), APMTD (p = 0.039) and HGSD (p = 0.002). After binary logistic regression adjusted for age and sex, the reduced HGSD remained associated with the risk of sarcopenia. Conclusion: SARC-CalF identified a risk of sarcopenia in 39.2% of patients. The reduced HGSD was associated with the risk of sarcopenia.

Impaired Hand Grip Strength Correlates with Greater Disability and Symptom Severity in Post-COVID Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Background: Post-COVID syndrome (PCS) encompasses a diverse array of symptoms persisting beyond 3 months after acute SARS-CoV-2 infection, with mental as well as physical fatigue being the most frequent manifestations. Methods: In 144 female patients with PCS, hand grip strength (HGS) parameters were assessed as an objective measure of muscle fatigue, with 78 meeting the Canadian Consensus Criteria for postinfectious myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The severity of disability and key symptoms was evaluated using self-reported questionnaires. Results: Patients with ME/CFS exhibited heightened overall symptom severity, including lower physical function (p < 0.001), a greater degree of disability (p < 0.001), more severe fatigue (p < 0.001), postexertional malaise (p < 0.001), and autonomic dysfunction (p = 0.004) compared to other patients with PCS. While HGS was impaired similarly in all patients with PCS and exhibited a significant correlation with physical function across the entire patient group, HGS of patients with ME/CFS uniquely demonstrated associations with key symptoms. Conclusions: Thus, impaired HGS serves as an objective marker of physical function in patients with PCS. Only in patients meeting ME/CFS criteria is impaired HGS also associated with the severity of hallmark symptoms. This suggests a common mechanism for muscle fatigue and other symptoms in the ME/CFS subtype, distinct from that in other types of PCS.

Clinical Relevance of Physical Function Outcomes in Cancer Cachexia.

Managing clinical manifestations of cancer/treatment burden on functional status and quality of life remains paramount across the cancer trajectory, particularly for patients with cachexia who display reduced functional capacity. However, clinically relevant criteria for classifying functional impairment at a single point in time or for classifying meaningful functional changes subsequent to disease and/or treatment progression are lacking. This unmet clinical need remains a major obstacle to the development of therapies for cancer cachexia. This review aims to describe current literature-based evidence for clinically meaningful criteria for (1) functional impairment at a single timepoint between cancer patients with or without cachexia and (2) changes in physical function over time across interventional studies conducted in patients with cancer cachexia. The most common functional assessment in cross-sectional and interventional studies was hand grip strength (HGS). We observed suggestive evidence that an HGS deficit between 3 and 6 kg in cancer cachexia may display clinical relevance. In interventional studies, we observed that long-duration multimodal therapies with a focus on skeletal muscle may benefit HGS in patients with considerable weight loss. Future studies should derive cohort-specific clinically relevant criteria to confirm these observations in addition to other functional outcomes and investigate appropriate patient-reported anchors.

Effectiveness of a high-intensity laser for improving hemiplegic shoulder dysfunction: a randomized controlled trial

Hemiplegic shoulder pain (HSP) is a common complication that occurs after stroke and has been reported in up to 84% of hemiplegic patients. One of the recommended treatment options for shoulder pain is high-intensity laser therapy (HILT). This study aimed to determine the effectiveness of high-intensity laser therapy on pain, function and hand grip strength in patients with hemiplegic shoulder dysfunction. Forty-four hemiplegic patients were randomly divided into two groups: Group 1 (study group, n = 22) received 3 HILT sessions a week for three weeks in combination with three sessions of therapeutic exercise per week for three weeks, and Group 2 (control group, n = 22) received a conventional exercise program for HSP three times a week for three weeks. Shoulder pain was evaluated using the McGill pain questionnaire (MPQ), the functional outcome of the shoulder was evaluated with the University of California–Los Angeles functional scale (UCLA), and handgrip strength was evaluated with a hydraulic hand dynamometer. The increase in the UCLA scores and the decrease in the MPQ scores after treatment were significant in the study group (p < 0.001) as well as in the control group (p < 0.05) in comparison with the pretreatment between-group comparison. Additionally, the increase in hand grip strength was significant in both groups after treatment (p < 0.001). The study group showed significant improvement over the control group with respect to the UCLA score, handgrip strength, and MPQ score (p < 0.001). HILT combined with therapeutic exercise provides greater improvement than therapeutic exercise alone in terms of hemiplegic shoulder pain, dysfunction, and handgrip strength.

Effect of dry needling on quality of life in patients with trigger finger: a randomized controlled trial

BackgroundAn inflammatory disorder known as trigger finger (TF) results in pain inthe proximal and distal palm and digit, as well as restricted movement and diminished function. Physiotherapists use a specific treatment called dry needling (DN) to reduce musculoskeletal pain and assist patients with mobility restriction.ObjectivesThis study aimed to examine the effectiveness of DN on quality of life in patients suffering from trigger finger.MethodsForty patients, ranging in age from 45 to 75, were randomized into one of two groups in this Prospective pre and post-test, single-blind parallel group randomized controlled trial. Twenty patients were assigned to the intervention group, which included traditional physiotherapy splinting and ultrasound (ultrasonic dosage was 3MHz, the intensity of 0.5 W/cm2, and the duty cycle 50%. Duration: 5 minutes) as well as to DN upon a nodule at the proximal end of the 1st annular (A1) pulley as well as the discrepancy that existed between the flexor tendon's diameter along with its sheath at the metacarpal head. Twenty patients were assigned to the control group, which consisted of traditional treatment alone, twice weekly, for a total of ten sessions over five weeks. The trial evaluated the quality of life, severity of pain, and hand grip strength using the World Health Organization Quality-of-Life Scale (WHOQOL-BREF), visual analogue scale, and Camry dynamometer respectively two times, beforetreatment and after 10 treatment sessions.ResultsWithin-group analysis using MANOVA demonstrated a significant decline in VAS (p = 0.001) and a significant improvement in quality of life (p = 0.001) and hand grip strength (p = 0.001). Regarding between group comparison using MANOVA there was significant improvement in favor of the DN intervention (p = 0.001) for all measured variables.ConclusionsA 5-week dry needling approach with a traditional physiotherapy program was effective in improving in quality of life, pain intensity, and hand grip strength in patients with trigger finger, emphasizing it as the better option.Trial registration:Clinical Trial. Gov, NCT05671523. Registered 14 December 2022.

Changes in Nutritional Intake, Body Composition, and Handgrip Strength in Patients Undergoing Autologous Hematopoietic Stem Cell Transplantation: A Retrospective Study

Patients who undergo autologous hematopoietic stem cell transplantation (autoHSCT) often experience reduced oral intake and wasting. We examined their daily nutritional intake, assessed alterations in body composition and muscle strength, and explored associations between decreased nutritional intake and treatment outcomes. This retrospective study included 64 patients. Their food record charts and parenteral nutrition (PN) prescriptions from medical records were used to assess nutritional intake. Body composition and handgrip strength data were obtained from dietitian records. Patients consumed >75% of their nutritional requirements through an oral diet in 6.7 days, 50–75% in 4.8 days, 25–50% in 5.0 days, and <25% in 3.1 days. The average oral intake was 62% of the requirement and was partially supplemented with PN. Patients experienced a mean decrease in body weight of 2.9 ± 3.0 kg, with 2.3 ± 3.4 kg of lean mass, and a mean reduction in handgrip strength of 3.5 ± 3.6 kg. We found a positive correlation of caloric deficits with weight loss and handgrip strength reduction and negative correlation with time to neutrophil engraftment and duration of hospitalization. This study highlighted a notable reduction in oral nutritional intake following autoHSCT. While caloric deficits might affect outcomes, further investigation is warranted to explore this observation.

Changes in walking speed 6 months after discharge may be more sensitive to subsequent prognosis than handgrip strength in patients hospitalized for heart failure

BackgroundDespite the prognostic importance of walking speed (WS) and handgrip strength (HGS) in patients with heart failure (HF), no study has reported the prognostic impact of changes in these parameters. This study aimed to examine the association between changes after discharge and the subsequent prognosis. MethodsThis study included 881 elderly patients hospitalized for HF. WS and HGS were measured at discharge and 6 months after discharge. Based on the presence of slowness (WS <0.98 m/s) or weakness (HGS <30.0 kg for men and < 17.5 kg for women) at both points, patients were divided into four groups (WS: A = −/−, B = −/+, C = +/−, D = +/+; HGS: E = −/−, F = −/+, G = +/−, H = +/+). The study endpoint was a composite of all-cause mortality and HF rehospitalization during the 18 months after 6 months of discharge. The Cox proportional hazards model was used to assess the association between the groups and study outcomes. ResultsStratified by the WS change patterns, groups B and D showed higher risk of the study outcomes than group A [B: hazard ratio 2.34, 95% confidence interval (CI) 1.29–4.28; D: 2.38, 1.67–3.39], whereas group C was not. When stratified by the HGS change in patterns, only group H was associated with a worse prognosis (HR; 1.85, 95%CI; 1.31–2.60). ConclusionChanges in WS were related to HF prognosis, suggesting that changes in WS may be more sensitive to further risk stratification than changes in HGS.

Assessment of the Correlation Between Serum Phosphate Level and Muscle Strength as Measured by Handgrip Strength in Patients Treated With Hemodialysis.

Sarcopenia, commonly observed in patients treated with hemodialysis, correlates with low serum phosphate levels. Although normophosphatemia is desired, dietary phosphate restriction is difficult to achieve and may result in undesirable protein restriction. We aimed to evaluate whether hyperphosphatemia is associated with higher muscle strength in patients receiving hemodialysis treatment. A single-center prospective observational study. Ambulatory prevalent patients undergoing hemodialysis treatments in a dialysis unit of a tertiary hospital. Participants included prevalent patients treated with hemodialysis. All patients were above 18 years. Only patients with residual kidney function below 200 mL/24 hours were included to avoid bias. Muscle strength was measured by handgrip strength (HGS). Each patient repeated 3 measurements, and the highest value was recorded. Handgrip strength cutoffs for low muscle strength were defined as <27 kg in men and <16 kg in women. Biochemical parameters, including serum phosphate level, were driven from routine monthly blood tests. Hyperphosphatemia was defined as serum phosphate above 4.5 mg/dL. Handgrip strength results were compared to nutritional, anthropometric, and biochemical parameters-in particular phosphate level. Long-term mortality was recorded. Seventy-four patients were included in the final analysis. Handgrip strength was abnormally low in 33 patients (44.5%). Patients with abnormal HGS were older and more likely to have diabetes mellitus and lower albumin and creatinine levels. There was no correlation between HGS and phosphate level (r = 0.008, P = .945). On multivariable analysis, predictors of higher HGS were body mass index and creatinine. Diabetes mellitus and female sex predicted lower HGS. Hyperphosphatemia correlated with protein catabolic rate, blood urea nitrogen, and creatinine. On multivariable analysis, predictors of hyperphosphatemia were higher creatinine level, normal albumin level, and heart failure. During mean follow-up time of 7.66 ± 3.9 months, 11 patients died. Mortality was significantly higher in patients with abnormally low HGS compared with normal HGS (odds ratio = 9.32, P = .02). A single-center study. All measurements were performed at one time point without repeated assessments. Direct dietary intake, degree of physical activity, and medication compliance were not assessed. Hyperphosphatemia correlated with increased protein intake as assessed by protein catabolic rate in patients treated with hemodialysis; however, neither correlated with higher muscle strength as measured by HGS.Trial registration: MOH 202125213.

Association between hearing loss and physical performance in patients on maintenance hemodialysis.

The correlation between hearing loss (HL) and physical performance in patients receiving maintenance hemodialysis (MHD) remains poorly investigated. This study explored the association between HL and physical performance in patients on MHD. This multicenter cross-sectional study was conducted between July 2020 and April 2021 in seven hemodialysis centers in Shanghai and Suzhou, China. The hearing assessment was performed using pure-tone average (PTA). Physical performance was assessed using the Timed Up and Go Test (TUGT), handgrip strength, and gait speed. Finally, 838 adult patients (male, 516 [61.6%]; 61.2 ± 2.6 years) were enrolled. Among them, 423 (50.5%) had mild to profound HL (male, 48.6% and female, 53.4%). Patients with HL had poorer physical performance than patients without HL (p < 0.001). TUGT was positively correlated with PTA (r = 0.265, p < 0.001), while handgrip strength and gait speed were negatively correlated with PTA (r = -0.356, p < 0.001 and r = -0.342, p < 0.001, respectively). Physical performance in patients aged <60 years showed significant dose-response relationships with HL. After adjusting for confounders, the odds ratios (95% confidence intervals) for HL across the TUGT quartiles (lowest to highest) were 1.00 (reference), 1.15 (0.73-1.81), 1.69 (1.07-2.70), and 2.87 (1.69-4.88) (p for trend = 0.005). Lower prevalence of HL was associated with a faster TUGT and a stronger handgrip strength in patients on MHD.

Comparison of nerve versus tendon transfer for radial nerve palsy

ObjectiveThis study aims to investigate the choice of intervention time and operation mode between nerve and tendon transfer for the treatment of radial nerve palsy (RNP). Methods46 RNP patients underwent nerve transfer (n = 22) and tendon transfer (n = 24). The intraoperative blood loss, main incision length, operation duration, and length of hospital stay and follow-up period of patients in these two groups were recorded and compared. The range of motion (ROM) of the elbow, wrist, fingers, and thumb, the hand grip and pinch strength, the Disabilities of Arm, Shoulder, and Hand (DASH) and the 36-Item Short Form Health Survey (SF-36) scores were measured and compared preoperatively and postoperatively between the two groups. ResultsThe ROM of thumb and the hand grip strength of patients in the nerve transfer group were greater than that in the tendon transfer (P < 0.05). Both of the two groups indicated significant improvements in the ROM of elbow, wrist, finger, thumb and the hand grip and pinch strength (P < 0.05) postoperatively. The DASH scores decreased significantly at 6 months (P < 0.05) and 12 months (P < 0.05) after surgery in both groups, while the postoperative SF-36 scores significantly increased (P < 0.05). There was no significant difference in postoperative DASH and SF-36 scores between the two groups (P > 0.05). ConclusionIn summary, both nerve and tendon transfer techniques are effective treatments for RNP. Nerve transfer is particularly advantageous for early RNP, while tendon transfer is suitable for patients with radial nerve injury more than one year.

The association between blood nickel level and handgrip strength in patients undergoing maintenance hemodialysis

BackgroundProgressive loss of peripheral muscle strength is highly pronounced in patients receiving maintenance hemodialysis (MHD), of which the pathological mechanism tends to be multifactorial. Plasma nickel was reportedly correlated with muscular strength in non-dialysis patients. However, scarce is known regarding the association between blood nickel level and handgrip strength among the patients undergoing MHD.MethodsThis cross-sectional study included patients undergoing MHD at our center in October 2021. Blood samples were collected before the hemodialysis sessions. Nickel level was measured using inductively coupled plasma mass spectrometry. Eligible patients were stratified into three groups by the blood nickel level: tertile 1 (≥ 5.2 ug/L); tertile 2 (< 5.2 ug/L and ≥ 4.5 ug/L); and tertile 3 (< 4.5 ug/L). Handgrip strength measurement was used to evaluate the muscle status. Spearman’s analyses and multivariable linear regression analyses were performed to study the relationship between blood nickel level and handgrip strength.ResultsA total of 236 patients were enrolled, with an average age of 55.51 ± 14.27 years and a median dialysis vintage of 83 (IQR: 48–125) months. Patients in group with a higher blood nickel level (tertile 1) tended to be female, had longer dialysis vintage and higher Kt/V, but lower BMI, serum creatinine, hemoglobin, and handgrip strength level (all p < 0.05). After adjustment for confounding factors in multivariable models, for every 1ug/L increase in nickel level, the patient’s handgrip strength decreases by 2.81 kg (β: − 2.810, 95% confidence interval: − 5.036 to − 0.584, p = 0.014). Restricted cubic spline confirmed the relationship was nearly linear.ConclusionsOur study highlighted that blood nickel level was related to handgrip strength in patients undergoing MHD. Prospective studies with larger sample sizes are still needed to confirm the result.

A Trend of High-Fat and Low-Carbohydrate Oral Nutritional Supplements on Body Composition and Handgrip Strength in Individuals with Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease is linked to malnutrition, leading to abnormal body composition and handgrip strength. Avoiding an increased respiratory quotient during malnutrition correction in chronic obstructive pulmonary disease is crucial. This study investigates the impact of high-fat, low-carbohydrate oral nutritional supplements on the body composition and handgrip strength of patients with chronic obstructive pulmonary disease. In our prospective intervention study, patients were randomly allocated to either the oral nutritional supplements or control groups. Both received dietary guidance and medication, while only the oral nutritional supplements group received high-fat, low-carbohydrate supplements. Body composition and handgrip strength were measured at baseline and 8 weeks later. Findings revealed that, after 8 weeks, the oral nutritional supplements group showed less handgrip strength improvement, a greater decrease in extracellular water ratio, and greater increases in weight, muscle, fat, and water compared to controls. In essence, oral nutritional supplement intervention appears to have a beneficial effect on body composition, especially in terms of muscle, fat, and water content, for chronic obstructive pulmonary disease patients. However, further studies with larger cohorts and extended durations are suggested to validate these findings.

Virtual reality-based exercises to improve balance and hand grip strength in patients with hemiparesis caused by an electrical burn: A randomized controlled study

There are many complications after an electrical burn injury, including neuromuscular defects, paresis or paralysis, Gillian barre syndrome, transverse myelitis, or amyotrophic lateral sclerosis. The aim of this study was to investigate the effect of virtual reality-based exercises on balance and hand grip strength in post electrical burn-induced hemiparetic patients. A randomized control trial pre- and post-experimental design with intra-rater reliability and inter-rater agreement was undertaken. Thirty post-electrical burn-induced hemiparetic patients (19 males and 11 females, aged 15 to 25 years) were randomly allocated into two equal groups (group A and B). Group A (n = 15) received virtual reality-based exercise in addition to the conventional physical therapy program. Group B (n = 15) received conventional physical therapy program only. The treatment was applied 3 sessions per week for 12 consecutive weeks. Posture stability and hand grip strength were measured by the Biodex balance system and handheld dynamometer, respectively. Data was collected prior to the first treatment and at the end of the 12-week trial and all statistical calculations were done using the computer program IBM SPSS. A statistically significant increase in the overall stability index and the power of hand grip strength was observed in both groups after treatment (p &lt; 0.05), especially in group A, which received VR - based exercise training. Thus, group A showed a greater improvement in postural stability and hand grip strength than group B (p &lt; 0.05). Virtual reality-based exercises as well as conventional physical therapy program were effective in improving posture stability and hand grip strength in post electrical burn-induced hemiparetic patients.

SEMG-controlled forearm bracelet and serious game-based rehabilitation for training manual dexterity in people with multiple sclerosis: a randomised controlled trial

BackgroundMuscle strength and dexterity impairments are common among patients with multiple sclerosis (MS) producing limitations in activities of daily living related to the upper limb (UL). This study aimed to evaluate the effectiveness of serious games specifically developed for the MYO Armband® capture sensor in improving forearm and wrist mobility, UL muscle strength, dexterity, fatigue, functionality, quality of life, satisfaction, adverse effects and compliance.MethodsA double-blinded (allocation concealment was performed by a blinded investigator and by blinding for assessors) randomised controlled trial was conducted. The sample was randomised into two groups: an experimental group that received treatment based on UL serious games designed by the research team and controlled by the MYO Armband® gesture capture sensor, along with conventional rehabilitation and a control group that received the same conventional rehabilitation for the UL. Both groups received two 60-min sessions per week over an eight-week period. Wrist range of motion (goniometry), grip muscle strength (Jamar® dynamometer), coordination and gross UL dexterity (Box and Block Test), fatigue (Fatigue Severity Scale), functionality (ABILHAND), quality of life (Multiple Sclerosis Impact Scale-29), adverse effects (Simulator Sickness Questionnaire, SSQ), perceived workload (NASA-Task load index), satisfaction (Client Satisfaction Questionnaire-8 (CSQ-8), Satisfaction with Technology Scale, System Usability Scale (SUS) and QUEST 2.0) and compliance (attendance) were assessed in both groups pre-treatment, post-treatment and during a follow-up period of 2 weeks without receiving any treatment.ResultsSignificant differences were observed in the experimental group compared to the control group in the assessment of forearm supination (p = .004) and grip strength (p = .004). Adverse effects were minimal (SSQ: 7/100 points) and perceived workload was low (NASA-Task Load Index: 25/100 points) in the experimental group. The MYO Armband® technology proved to be useful for the participants (SUS: 80.66/100) and the satisfaction scales received high scores (QUEST 2.0: 59.4/70 points; Satisfaction with Technology: 84.36/100 points). There were significant differences between the groups in terms of attendance percentage (p = .029).ConclusionsAn experimental protocol using MYO Armband®-based serious games designed for UL rehabilitation showed improvements in active wrist range of motion and handgrip strength in patients with MS, with high satisfaction, minimal adverse effects and workload and excellent compliance.Trial registration number: This randomised controlled trial has been registered at ClinicalTrials.gov Identifier: NCT04171908.

Handgrip Strength in Lung Transplant Candidates and Recipients.

Handgrip strength is increasingly used to assess muscle strength in various conditions. In this review, we investigated handgrip strength in patients receiving or awaiting lung transplant. For this integrative review, we searched 8 databases from inception through February 2023. Two keyword entries, "handgrip strength" and "lung transplantation," were matched using the Boolean operator, AND. No filters were applied for document type, age, sex, publication date, language, and subject. The searched databases returned 73 citations. Nine articles considering 487 patients (49% female) were included in the final analysis; 7 studies were observational, and 2 were randomized controlled trials. In 7 of 9 studies, handgrip strength was measured with a hydraulic dynamometer. In candidates for lung transplant, handgrip strength ranged from 27.1 kg (before rehabilitation) to 31.2 kg (after rehabilitation). In lung transplant recipients, handgrip strength ranged from 21.1 kg (before rehabilitation) to 35.7 kg (after rehabilitation). Handgrip strength in lung transplant candidates with chronic obstructive pulmonary disease was higher (89 ± 18% predicted) versus patients with interstitial lung disease (79 ± 18% predicted). Improvements in maximal inspiratory pressure and maximal expiratory pressure were observed in those patients whose handgrip strength improved after rehabilitation. Nonsarcopenic patients walked longer distances for the 6-minute walking test (>450 m) versus sarcopenic patients (<310 m) and had higher handgrip strength (>20 kg) versus sarcopenic patients (<20 kg). Handgrip strength testing should be implemented both in preoperative and postoperative contexts to evaluate physical potential of patients and drive rehabilitative activities toward the most impaired domains.

Comparison of Handgrip Strength among Diabetes Mellitus with and without Cervical Radiculopathy

Background: Patients with Diabetes Mellitus type 2 have reported to be more disabled in self-care tasks and other daily living activities because of many hand complications. There is reduction in grip strength in diabetic population. The purpose of this study was to compare hand grip strength among diabetes mellitus with and without cervical radiculopathy. A dynamometer can be used to swiftly and precisely measure the link between diabetic patient’s hand grip strength and their blood sugar levels. Objective(s): The study's objective was to evaluate the comparison of hand grip strength among diabetes mellitus with and without cervical radiculopathy. Methodology: A Cross-sectional study was carried among 385 diabetic patients with and without cervical radiculopathy from age 35-75. Data collected from two hospitals of Gujrat City. The study was completed June 2022 to October 2022 within 4 months by non-probability convenient sampling. Both genders were included. Instruments used in this study were handheld dynamometer. We were start to measure handgrip strength in both dominant and non-dominant hand of diabetic patients with and without cervical radiculopathy. Result was analyzed by SPSS version 24; mean and standard deviation were calculated for quantitative variables whereas frequency and percentages were used for qualitative variables. Results: The results had been obtained from 385 diabetic patients (50.6%) were females and (49.4%) were males. In our study the data was collected on the bases of age, gender, socioeconomic status, area and dominancy of hand. 61(32.28%) diabetic patients with cervical radiculopathy hand grip strength are more effected as compared to those without cervical radiculopathy that were 15(7.94%) and there (P&lt;0.001) which indicates it is statistically significant. Practical Implication: The study suggests that fewer patients were diagnosed with cervical radiculopathy in diabetic patients and more patients were without cervical radiculopathy. Conclusion(s): This study concluded that the hand grip strength of patients with cervical radiculopathy prone to diabetes was affected highly as compared to those of which were not diagnosed with cervical radiculopathy but with diabetes. Although our study suggests that less patients were diagnosed with cervical radiculopathy in diabetic patients and more patients were without cervical radiculopathy, our study also proves that diabetic patients are also likely to develop neuropathies in later ages. Keywords: Hand grip strength, Handheld Dynamometer, Cervical Radiculopathy, Diabetes Mellitus

Does Hand Grip Strength (HGS) Predict Functional Independence Differently in Patients Post Hip Replacement Due to Osteoarthritis versus Patients Status Post Hip Replacement Due to a Fracture?

The aim of the study was to determine whether hand grip strength (HGS) predicts functional independence in older patients who have undergone hip replacement due to osteoarthritis versus older patients who have undergone hip replacement surgery due to fracture. The study included 239 patients aged 65 and over in the first weeks after total hip replacement during rehabilitation treatment. Multivariate linear regression was used to determine HGS as a predictor of activities of daily living (ADL) and instrumental activities of daily living (IADL) in both groups: patients post hip replacement due to osteoarthritis and patients post hip replacement due to a fracture. Analysis showed that pre-rehab HGS in the osteoarthritis group predicts improved activities of daily living after rehabilitation (ADL, OR = 1.098; CI 95% 1.052-1.147 and IADL, OR = 1.182; CI 95% 1.103-1.267) and 6 months after (ADL, OR = 1.191; CI 95% 1.066-1.329 and IADL, OR = 1.096; CI 95% 1.012-1.186). In the fracture group, HGS predicts the ADL (OR = 1.081; CI 95% 1.015-1.152) after rehabilitation, and IADL after rehabilitation (OR = 1.122; CI 95% 1.046-1.205) and 6 months after (OR = 1.090; 95% CI 1.021-1.64). HGS in patients after hip replacement surgery predicts functional independence in basic and complex activities of daily living. This can allow the identification of osteoarthritis patients with low hand grip - who can be considered as patients with a higher risk of an unsatisfying outcome of surgery. These patients should undergo pre-rehabilitation and should be monitored, and/or supported in terms of rehabilitation after discharge.