Sartorio Francesco, Lippi Lorenzo, Vercelli Stefano, Gallo Federica, Zanin Davide, Bergesio Sara, de Sire Alessandro, Invernizzi Marco
Division of Physical Medicine and Rehabilitation, ICS Maugeri SPA SB, Institute of Veruno, IRCCS, 28010, Novara, Veruno, Italy.
Department of Scientific Research, Campus LUdeS, Off-Campus Semmelweis University of Budapest, Budapest, 1085, Hungary.
BMC Musculoskelet Disord. 2025 Jan 2;26(1):5. doi: 10.1186/s12891-024-08222-2.
Hand grip strength (HGS) is an important measure in a physiotherapy assessment and for this purpose it is necessary to have valid and reliable instruments to measure it. In this study we aimed at investigating the reliability, validity, and agreement of the new hand-held dynamometer NOD (OT-Bioelettronica, To-Italy) compared to Jamar® hydraulic dynamometer (JD), the gold standard.
Fifty healthy subjects were selected; 9 trials for the dominant hand and 9 trials for the non-dominant hand were administrated to each of them: 3 trials of HGS with the JD in rung #3, 3 trials with the JD-adapted-grip (like the NOD one), and 3 trials with NOD. To verify the reliability of NOD, the Intraclass Correlation Coefficient (ICC 3,1) was calculated with a mixed effects model with the addition of adjustment variables (age, gender, dominant / non-dominant limb, trials). The model used single HGS measurements to estimate variance components, so reflecting both degree of correspondence and agreement among devices. To assess concurrent validity NOD was compared to the "gold standard" JD, in terms of ICCs and through Pearson correlation. The agreement between the methods of measurement was calculated with the Limits of Agreement (LoA) and the plots of Bland-Altman.
All ICCs show high inter-reliability; the results are very similar for both dynamometers. The value of the adjusted ICC of NOD was 0.90. For validity, Pearson correlations of NOD towards JD and JD-adapted-grip were high (r = 0.87 and 0.88). However, the LoA and the plots of Bland-Altman demonstrated that there is no agreement between NOD and JD and between NOD and JD-adapted-grip, with NOD showing lower mean scores than JD.
NOD is a reliable and valid instrument for HGS. However, even if it cannot be considered interchangeable with JD because there is no agreement between them in free-living adults, NOD is easier to carry than other dynamometers, it has a Bluetooth® connection with a free App and it is a multi-purpose tool that should be considered both in daily practice and in clinical settings.
握力（HGS）是物理治疗评估中的一项重要指标，因此需要有效且可靠的测量工具。在本研究中，我们旨在探究新型手持测力计NOD（OT - 生物电子公司，意大利托）与金标准Jamar®液压测力计（JD）相比的可靠性、有效性和一致性。
选取50名健康受试者；对每人的优势手进行9次测试，非优势手也进行9次测试：在第3档使用JD进行3次HGS测试，使用JD适配握法（类似NOD的握法）进行3次测试，以及使用NOD进行3次测试。为验证NOD的可靠性，采用混合效应模型计算组内相关系数（ICC 3,1），并添加调整变量（年龄、性别、优势/非优势肢体、测试次数）。该模型使用单次HGS测量值来估计方差分量，从而反映设备之间的对应程度和一致性。为评估同时效度，通过ICC以及皮尔逊相关性将NOD与“金标准”JD进行比较。测量方法之间的一致性通过一致性界限（LoA）和布兰德 - 奥特曼图进行计算。
所有ICC均显示出高内部可靠性；两种测力计的结果非常相似。NOD的调整后ICC值为0.90。在有效性方面，NOD与JD以及JD适配握法的皮尔逊相关性较高（r = 0.87和0.88）。然而，LoA和布兰德 - 奥特曼图表明，NOD与JD以及NOD与JD适配握法之间不存在一致性，NOD的平均得分低于JD。
NOD是一种用于测量HGS的可靠且有效的工具。然而，尽管由于在自由生活的成年人中它们之间不存在一致性，NOD不能被视为与JD可互换，但NOD比其他测力计更易于携带，它具有与免费应用程序的蓝牙®连接，并且是一种多功能工具，在日常实践和临床环境中均应予以考虑。
