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  • Muscle strength assessment in critically ill patients with handheld dynamometry: An investigation of reliability, minimal detectable change, and time to peak force generation

    Author(s)
    E. Baldwin, Claire
    Paratz, Jennifer D.
    D. Bersten, Andrew
    Griffith University Author(s)
    Paratz, Jenny D.
    Year published
    2013
    Metadata
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    Abstract
    Purpose Dynamometry is an objective tool for volitional strength evaluation that may overcome the limited sensitivity of the Medical Research Council scale for manual muscle tests, particularly at grades 4 and 5. The primary aims of this study were to investigate the reliability, minimal detectable change, and time to peak muscle force, measured with portable dynamometry, in critically ill patients. Materials and methods Isometric hand grip, elbow flexion, and knee extension were measured with portable dynamometry. Results Interrater consistency (intraclass correlation coefficient [95% confidence interval]) (0.782 [0.321-0.930] ...
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    Purpose Dynamometry is an objective tool for volitional strength evaluation that may overcome the limited sensitivity of the Medical Research Council scale for manual muscle tests, particularly at grades 4 and 5. The primary aims of this study were to investigate the reliability, minimal detectable change, and time to peak muscle force, measured with portable dynamometry, in critically ill patients. Materials and methods Isometric hand grip, elbow flexion, and knee extension were measured with portable dynamometry. Results Interrater consistency (intraclass correlation coefficient [95% confidence interval]) (0.782 [0.321-0.930] to 0.946 [0.840-0.982]) and test-retest agreement (0.819 [0.390-0.943] to 0.918 [0.779-0.970]) were acceptable for all dynamometry forces, with the exception of left elbow flexion. Despite generally good reliability, a mean change (upper 95% confidence interval) of 2.8 (7.8) kg, 1.9 (5.2) kg, and 2.6(7.1) kg may be required from a patient's baseline force measurement of right grip, elbow flexion, and knee extension to reflect real force changes. There was also a delay in the time for critically ill patients to generate peak muscle forces, compared with healthy controls (P = .001). Conclusions Dynamometry can provide reliable measurements in alert critically ill patients, but moderate changes in strength may be required to overcome measurement error, during the acute recovery period. Deficits in force timing may reflect impaired neuromuscular control.
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    Journal Title
    Journal of Critical Care
    Volume
    28
    Issue
    1
    DOI
    https://doi.org/10.1016/j.jcrc.2012.03.001
    Subject
    Physiotherapy
    Clinical Sciences
    Nursing
    Publication URI
    http://hdl.handle.net/10072/60103
    Collection
    • Journal articles

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