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Hand grip strength assessment in older people: is the supine position valid and reliable?
Benedetta Govoni1, Giacomo Mantovani1, Elisa Maietti2,3
1Department of Medical Sciences, Geriatric and Orthogeriatric Unit S. Anna Hospital, University of Ferrara, Via Ariosto, 35, 44121, Ferrara, Italy.
Purpose:
Muscle strength evaluation is important in older people's functional assessment. We investigated the validity of grip strength measurement in a supine position as compared to the traditional one.
Methods:
Cross-sectional study conducted in older people hospitalized in a medical unit. Patients underwent measurements of grip strength in both supine and sitting positions. Agreement between results was evaluated using Pearson correlation and Infraclass correlation coefficient. The two measurements techniques were graphically compared with Bland-Altman plot.
Results:
Forty four participants enrolled (21 females), mean age 80.6. Correlation coefficients demonstrated a strong positive relationship between the two different measurement positions (all values greater than 0.9). Results were consistent and similar across gender, body side and were not affected by cognitive impairment. Infraclass correlation analyses demonstrate a very good inter-rate reliability.
Conclusions:
Grip strength assessed in the supine position can be considered a valid alternative in bedridden individuals.
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Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.

