Draak Thomas H P, Pruppers Mariëlle H J, van Nes Sonja I, Vanhoutte Els K, Bakkers Mayienne, Gorson Kenneth C, Van der Pol W-Ludo, Lewis Richard A, Notermans Nicolette C, Nobile-Orazio Eduardo, Léger Jean-Marc, Van den Bergh Peter Y K, Lauria Giuseppe, Bril Vera, Katzberg Hans, Lunn Michael P T, Pouget Jean, van der Kooi Anneke J, van den Berg Leonard H, van Doorn Pieter A, Cornblath David R, Hahn Angelika F, Faber Catharina G, Merkies Ingemar S J
Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
Department of Neurology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
J Peripher Nerv Syst. 2015 Sep;20(3):269-76. doi: 10.1111/jns.12126.
The Jamar dynamometer and Vigorimeter have been used to assess grip strength in immune-mediated neuropathies, but have never been compared to each other. Therefore, we performed a comparison study between these two devices in patients with immune-mediated neuropathies. Grip strength data were collected in 102 cross-sectional stable and 163 longitudinal (new diagnoses or changing condition) patients with Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), gammopathy-related polyneuropathy (MGUSP), and multifocal motor neuropathy (MMN). Stable patients were assessed twice (validity/reliability studies). Longitudinal patients were assessed 3-5 times during 1 year. Responsiveness comparison between the two tools was examined using combined anchor-/distribution-based minimum clinically important difference (MCID) techniques. Patients were asked to indicate their preference for the Jamar or Vigorimeter. Both tools correlated highly with each other (ρ = 0.86, p < 0.0001) and showed good intra-class correlation coefficients (Jamar [Right/Left hands]: ICC 0.997/0.96; Vigori: ICC 0.95/0.98). Meaningful changes were comparable between the two instruments, being higher in GBS compared to CIDP patients. In MGUSP/MMN poor responsiveness was seen. Significant more patients preferred the Vigorimeter. In conclusion, validity, reliability, and responsiveness aspects were comparable between the Jamar dynamometer and Vigorimeter. However, based on patients' preference, the Vigorimeter is recommended in future studies in immune-mediated neuropathies.
Jamar握力计和Vigorimeter握力计已被用于评估免疫介导性神经病患者的握力,但两者从未进行过相互比较。因此,我们对这两种设备在免疫介导性神经病患者中进行了一项比较研究。收集了102例横断面病情稳定的患者以及163例纵向(新诊断或病情变化)的吉兰-巴雷综合征(GBS)、慢性炎症性脱髓鞘性多发性神经根神经病(CIDP)、丙种球蛋白病相关多发性神经病(MGUSP)和多灶性运动神经病(MMN)患者的握力数据。对病情稳定的患者进行了两次评估(效度/信度研究)。纵向患者在1年内接受了3至5次评估。使用基于锚定和分布的联合最小临床重要差异(MCID)技术检查了两种工具之间的反应性比较。患者被要求表明他们对Jamar握力计或Vigorimeter握力计的偏好。两种工具之间的相关性都很高(ρ = 0.86,p < 0.0001),并且显示出良好的组内相关系数(Jamar[右手/左手]:ICC 0.997/0.96;Vigorimeter:ICC 0.95/0.98)。两种仪器之间有意义的变化具有可比性,GBS患者的变化高于CIDP患者。在MGUSP/MMN中观察到反应性较差。明显更多的患者更喜欢Vigorimeter握力计。总之,Jamar握力计和Vigorimeter握力计在效度、信度和反应性方面具有可比性。然而,基于患者的偏好,建议在未来免疫介导性神经病的研究中使用Vigorimeter握力计。