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Muscle analysis by measurement of maximal isometric grip force: new reference data and clinical applications in
Frank Rauch1, Christina M Neu, Gernot Wassmer
1Children's Hospital, University of Cologne, Cologne, Germany. frauch@shriners.mcgill.ca
Insights
Maximal isometric grip force (MIGF) in children is influenced by body size, not just age. Adjusting for height is crucial for accurate assessment of muscle function in pediatric patients with growth disorders.
Area of Science:
- Pediatric physical development
- Skeletal muscle function assessment
- Growth and development studies
Background:
- Skeletal muscle development is vital during childhood and adolescence.
- Maximal isometric grip force (MIGF) quantifies muscle function but is often compared to age-only data.
- Growth retardation in chronic pediatric disorders can affect muscle performance metrics.
Purpose of the Study:
- To establish reference data for MIGF in healthy children and adolescents.
- To evaluate the impact of body size (height) on MIGF in pediatric patient groups.
- To determine if height-adjusted MIGF (SDS) provides a more accurate assessment than age-adjusted MIGF.
Main Methods:
- Collected MIGF data from 315 healthy children and adolescents (ages 6-19).
- Developed regression models for MIGF based on chronological age and height.
- Calculated age- and height-dependent SD scores (SDS) for MIGF in patient cohorts.
Main Results:
- Renal graft recipients and cystic fibrosis patients showed decreased age-dependent MIGF SDS but near-normal height-dependent MIGF SDS.
- Children with epilepsy on anticonvulsants had similar age- and height-dependent MIGF SDS due to normal stature.
- Height significantly influences MIGF, impacting interpretation of muscle function in growth-retarded children.
Conclusions:
- MIGF is a valuable indicator of physical development in children.
- Height-dependent assessment of MIGF is essential to avoid misinterpreting muscle function in pediatric patients.
- Standardized reference data accounting for both age and height are needed for accurate clinical evaluation.
Abstract:
Skeletal muscle development is one of the key features of childhood and adolescence. Determining maximal isometric grip force (MIGF) using a hand-held Jamar dynamometer is a simple method to quantify one aspect of muscle function. Presently available reference data present MIGF as a function of chronological age. However, muscle force is largely determined by body size, and many children undergoing muscle performance tests in the clinical setting suffer from growth retardation secondary to a chronic disorder. Reference data were established from simple regressions between age or log height and log MIGF in a population of 315 healthy children and adolescents aged 6 to 19 y (157 girls). These data were used to calculate age- or height-dependent SD scores (SDS) for MIGF in three pediatric patient groups. In renal graft recipients (n = 14), the age-dependent MIGF SDS was markedly decreased (-2.5 +/- 1.9; mean +/- SD). However, these patients had short stature (height SDS, -2.5 +/- 1.2), and the height-dependent MIGF SDS was close to normal (-0.4 +/- 1.5). Similarly, in cystic fibrosis patients (n = 13) age-dependent MIGF SDS was -1.6 +/- 1.6, but height-dependent MIGF SDS was -0.5 +/- 1.1. Children with epilepsy who were taking anticonvulsant therapy (n = 34) had normal stature, and consequently age- and height-dependent MIGF SDS were similar (0.4 +/- 1.0 and 0.4 +/- 0.8, respectively). In conclusion, MIGF determination provides information on an important aspect of physical development. Height should be taken into account to avoid misinterpretation.