[Abstract] 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.

via Measurement Properties of the Hand Grip Strength Assessment. A Systematic Review with Meta-analysis – Archives of Physical Medicine and Rehabilitation

[Abstract] Effect of motor imagery on walking function and balance in patients after stroke: A quantitative synthesis of randomized controlled trials

 

Highlights

• Motor imagery (MI) is a beneficial intervention for stroke rehabilitation.
• MI shows superior to routine methods of treatment or training in improving walking and motor function.
• Effects of MI on walking and motor function are not affected by treatment duration.

Abstract

Objective

This study aimed to evaluate effects of motor imagery (MI) on walking function and balance in patients after stroke.

Methods

Related randomized controlled trials (RCTs) were searched in 12 electronic databases (Cochrane Central Register of Controlled Trials, PubMed, Science Direct, Web of Science, Allied and Complementary Medicine, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, WanFang, and VIP) from inception to November 30, 2016, and Review Manager 5.3 was used for meta-analysis. References listed in included papers and other related systematic reviews on MI were also screened for further consideration.

Results

A total of 17 studies were included. When compared with “routine methods of treatment or training,” meta-analyses showed that MI was more effective in improving walking abilities (standardized mean difference [SMD] = 0.69, random effect model, 95% confidence interval [CI] = 0.38 to 1.00, P < 0.0001) and motor function in stroke patients (SMD = 0.84, random effect model, 95% CI = 0.45 to 1.22, P < 0.0001), but no statistical difference was noted in balance (SMD = 0.78, random effect model, 95% CI = −0.07 to 1.62, P = 0.07). Statistically significant improvement in walking abilities was noted between short-term (0 to < six weeks) (SMD = 0.83, fixed effect model, 95% CI = 0.24 to 1.42, P = 0.006) and long-term (≥six weeks) durations (SMD = 0.45, fixed effect model, 95% CI = 0.25 to 0.64, P < 0.00001). Subgroup analyses results suggested that MI had a positive effect on balance with short-term duration (0 to < six weeks) (SMD = 4.67, fixed effect model, 95% CI = 2.89 to 6.46, P < 0.00001), but failed to improve balance (SMD = 0.82, random effect model, 95% CI = −0.27 to 1.90, P = 0.14) with long-term (≥six weeks) duration.

Conclusion

MI appears to be a beneficial intervention for stroke rehabilitation. Nonetheless, existing evidence regarding effectiveness of MI in stroke patients remains inconclusive because of significantly statistical heterogeneity and methodological flaws identified in the included studies. More large-scale and rigorously designed RCTs in future research with sufficient follow-up periods are needed to provide more reliable evidence on the effect of MI on stroke patients.

Source: Effect of motor imagery on walking function and balance in patients after stroke: A quantitative synthesis of randomized controlled trials – Complementary Therapies in Clinical Practice