Document Detail


What is the minimum clinically important difference in grip strength?
MedLine Citation:
PMID:  24817380     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Grip strength reflects functional status of the upper extremity and has been used in many of the clinical studies regarding upper extremity disease or fracture. However, the smallest difference in grip strength that a patient would notice as an improvement resulting from treatment (defined as the minimum clinically important difference [MCID]), to our knowledge has not been determined.
QUESTIONS/PURPOSES: We asked (1) how 1-year postsurgery grip strength compares with preinjury values; (2) if grip strength correlated with patient's ratings; (3) what the MCID is in the grip strength; and (4) if these values are equivalent to or greater than what can be explained by measurement errors in patients treated for distal radius fracture.
METHODS: Fifty patients treated by volar locking plate fixation for a distal radius fracture constituted the study cohort. Grip strengths were measured 1 year after surgery on the injured and uninjured sides using a dynamometer. Grip strengths before injury were estimated using the grip strengths of the uninjured side with consideration of hand dominance. Patients were asked to rate their subjective level of grip strength weakness at 1 year postoperatively. Receiver operator characteristic curve analysis was used to determine MCIDs. Minimal detectable change in grip strength, which is a statistical estimate of the smallest change between two measurement points expected by measurement error or chance alone, also was determined using the formula 1.65 × √2 × standard error of measurement.
RESULTS: One year after surgery, grip strength (23 kg; 95% CI, 20-27) was less compared with calculated preinjury values (28 kg; 95% CI, 25-31; p < 0.001). Patients' rating of grip strength and measured grip strength changes correlated well (p = 0.56). MCIDs were 6.5 kg for grip strength and 19.5% for percentage grip strength. The MCID was not less than the minimum detectable change for grip strength (also 6.5 kg).
CONCLUSIONS: The MCID of the grip strength was a decrease of 6.5 kg (19.5%). We believe the MCID of grip strength is useful for evaluating effectiveness of new treatments and for determining appropriate sample size in clinical trials of distal radius fractures.
LEVEL OF EVIDENCE: Level III diagnostic study. See the Instructions for Authors for a complete description of levels of evidence.
Authors:
Jae Kwang Kim; Min Gyue Park; Sung Joon Shin
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2014-05-10
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  472     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-07-03     Completed Date:  2014-09-11     Revised Date:  2014-09-15    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2536-41     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Area Under Curve
Bone Plates
Female
Fracture Fixation, Internal* / instrumentation
Hand Strength*
Humans
Male
Middle Aged
Predictive Value of Tests
ROC Curve
Radius Fractures / physiopathology,  surgery*
Recovery of Function
Time Factors
Treatment Outcome
Comments/Corrections
Comment In:
Clin Orthop Relat Res. 2014 Sep;472(9):2857-8   [PMID:  25008203 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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