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Measuring hand intrinsic muscle strength: normal values and interrater reliability
Geraldine L Jacquemin1, Stephen P Burns, James W Little
1Spinal Cord Injury Service, Department of Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA. gjacquemin@yahoo.com
The Journal of Spinal Cord Medicine
|January 15, 2005
Summary
Measuring hand intrinsic muscle strength using a handheld myometer can help detect early signs of neurological decline in spinal cord injury (SCI) patients. This quantitative method aids in diagnosing complications and monitoring recovery.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Intrinsic hand muscles are crucial for upper limb function and are innervated by the lowest spinal cord segments.
- Peripheral nerve issues can impact hand strength in spinal cord injury (SCI) patients, necessitating reliable assessment methods.
- Early detection of neurological decline is vital for effective management of SCI and related myelopathies.
Purpose of the Study:
- To develop and validate a method for quantitatively measuring intrinsic hand muscle strength using a handheld myometer.
- To establish normative strength values for key hand muscles in able-bodied individuals.
- To assess the utility of these measurements in identifying weakness in individuals with SCI and evaluating interrater reliability.
Main Methods:
- A handheld myometer was used to measure the strength of second-digit abductors, fifth-digit abductors, and thumb opposers.
- Quantitative strength data were collected from 31 able-bodied participants and 24 individuals with SCI.
- Interrater reliability was assessed using the Bland-Altman method, and results were compared with manual muscle test scores.
Main Results:
- Mean strength in able-bodied individuals was 5.0 kg (2nd digit abduction), 3.1 kg (5th digit abduction), and 5.0 kg (thumb opposition).
- Lower limits of normal were established as 3.0 kg, 1.8 kg, and 3.4 kg, respectively.
- The 95th percentile for interrater differences ranged from 29.3% to 43.7% across the tested muscle groups.
Conclusions:
- Abnormal hand intrinsic strength is indicated by values below the 5th percentile or strength changes exceeding the 95th percentile for interrater differences.
- Quantitative hand strength measurements offer a valuable tool for the early diagnosis of secondary neurological complications in SCI.
- These objective measurements can significantly aid in monitoring neurological recovery and guiding treatment interventions for individuals with SCI.