Measurement Properties of the Hand Grip Strength Assessment. A Systematic Review with Meta-analysis

Abstract Objective The aim of this study was to critically appraise, compare and summarize the quality of the measurement properties of grip strength (GS) in healthy participants and patients with musculoskeletal, neurological or systemic conditions. Data Sources We followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline. To identify studies on measurement properties of GS, we searched the Medline, Embase, CINAHL, PEDro and Cochrane Library databases from inception till June 2019. Meta-analyses were carried out using a random effect model and 95% confidence intervals (CI) were calculated. Study Selection Studies were included if they reported at least 1 measurement property of hand GS in healthy patient population or with musculoskeletal, neurological and systemic conditions Data Extraction The extracted data included the study population, setting, sample size, measurement evaluated and the test interval. Data Synthesis Twenty-five studies were included with 1879 participants. The pooled results indicated excellent intra-class correlation coefficients (ICC) 0.92, 95% CI: -0.88 to 0.94 for healthy participants, ICC 0.95, 95% CI: -0.93 to 0.97 for upper extremity conditions and an ICC of 0.96, 95% CI: -0.94 to 0.97 for patients with neurological conditions. Minimum Clinically Important Difference (MCID) scores for hand GS were: 5.0 kg (dominant side) and 6.2 kg (non-dominant side) for post-stroke patients, 6.5 kg for the affected side after distal radius fracture, 10.5lbs and 10 kilopascals for immune-mediated neuropathies, 17kg for patients with lateral epicondylitis and 0.84 kg (affected side) and 1.12 kg (unaffected side) in the carpometacarpal osteoarthritis group, and MCID GS estimates of 2.69 – 2.44 kg in the healthy group Conclusion 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.