Dalla Lana School of Public Health, Institute of Health Policy Management and Evaluation, Department of Clinical Epidemiology and Health Care Research, University of Toronto, Toronto, Ontario, Canada; School of Physical Therapy, Faculty of Health Science, Western University, London, Ontario, Canada; Collaborative Program in Musculoskeletal Health Research, Western's Bone and Joint Institute, Western University, London, Ontario, Canada; Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ontario, Canada.
School of Physical Therapy, Faculty of Health Science, Western University, London, Ontario, Canada; Collaborative Program in Musculoskeletal Health Research, Western's Bone and Joint Institute, Western University, London, Ontario, Canada; Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, London, Ontario, Canada.
Arch Phys Med Rehabil. 2020 Mar;101(3):553-565. doi: 10.1016/j.apmr.2019.10.183. Epub 2019 Nov 13.
The aim of this study was to critically appraise, compare, and summarize the quality of the measurement properties of grip strength (GS) in patients with musculoskeletal, neurologic, or systemic conditions and healthy participants without these conditions.
We followed the Consensus-based Standards for the Selection of Health Measurement Instruments guideline. To identify studies on measurement properties of GS, we searched the MEDLINE, Embase, Cumulative Index to Nursing and Allied Health, Physiotherapy Evidence, and Cochrane Library databases from inception until June 2019. Meta-analyses were carried out using a random effects model and 95% CIs were calculated.
Studies were included if they reported at least 1 measurement property of hand GS in a population with musculoskeletal, neurologic, and systemic conditions or a healthy population without these conditions.
The extracted data included the study population, setting, sample size, measurement evaluated, and the test interval.
Twenty-five studies were included with 1879 participants. The pooled results indicated excellent intraclass correlation coefficient (ICC) of 0.92 (95% CI, -0.88-0.94 for healthy participants without any conditions, ICC of 0.95 (95% CI, -0.93-0.97) for upper extremity conditions, and an ICC of 0.96 (95% CI, -0.94-0.97) for patients with neurologic conditions. Minimum clinically important difference (MCID) scores for hand GS were 5.0 kg (dominant side) and 6.2 kg (nondominant side) for patients post stroke, 6.5 kg for the affected side after distal radius fracture, 10.5 lb and 10 kPa for immune-mediated neuropathies, 17 kg for patients with lateral epicondylitis, and 0.84 kg (affected side) and 1.12 kg (unaffected side) in the carpometacarpal osteoarthritis group; MCID GS estimates were 2.69-2.44 kg in the healthy group without conditions.
Our synthesized evidence indicated that GS assessment is a reliable and valid procedure among healthy participants as well as across various clinical populations. Furthermore, our MCID summary scores provided useful information for evaluating (clinical importance) new interventions regarding hand GS.
本研究旨在对患有肌肉骨骼、神经或系统性疾病以及无此类疾病的健康参与者的握力（GS）测量性能进行批判性评价、比较和总结。
我们遵循基于共识的健康测量仪器选择标准。为了确定关于 GS 测量性能的研究，我们从开始到 2019 年 6 月在 MEDLINE、Embase、护理与联合健康累积索引、物理治疗证据和 Cochrane 图书馆数据库中进行了搜索。使用随机效应模型进行荟萃分析，并计算 95%置信区间。
如果研究报告了患有肌肉骨骼、神经和系统性疾病或无此类疾病的健康人群中手 GS 的至少 1 项测量性能，则将其纳入研究。
提取的数据包括研究人群、设置、样本量、评估的测量和测试间隔。
共纳入 25 项研究，涉及 1879 名参与者。汇总结果表明，健康参与者（无任何疾病）的组内相关系数（ICC）为 0.92（95%置信区间，-0.88 至 0.94），上肢疾病患者的 ICC 为 0.95（95%置信区间，-0.93 至 0.97），神经疾病患者的 ICC 为 0.96（95%置信区间，-0.94 至 0.97）。手 GS 的最小临床重要差异（MCID）评分分别为 5.0 公斤（优势侧）和 6.2 公斤（非优势侧）的脑卒中患者、桡骨远端骨折后患侧 6.5 公斤、免疫介导性神经病患者 10.5 磅和 10 kPa、外侧上髁炎患者 17 公斤、腕掌关节炎组中患侧 0.84 公斤（患侧）和 1.12 公斤（健侧）；无疾病健康组的 MCID GS 估计值为 2.69-2.44 公斤。
我们综合的证据表明，GS 评估在健康参与者以及各种临床人群中是一种可靠和有效的方法。此外，我们的 MCID 总结评分提供了有关手 GS 新干预措施的评估（临床重要性）的有用信息。
