Hand grip strength in patients with LVADs: A scoping review

Hand grip strength (HGS) is a simple test to evaluate the upper limb strength function in patients with different diseases. The purpose of this review was to investigate HGS in patients who have been implanted with left ventricular assist devices (LVADs) or waiting for implantation. The objectives were: (1) defining if HGS can predict rehabilitative outcomes such as the walked distance at the 6-minute walking test, and (2) identifying specific HGS cut-off values.

We searched eight primary databases for English-language studies published from their inception until April 2021. We excluded editorials, letters to the editor, and studies that did not describe HGS assessment procedures.

A total of 30 articles were identified. We ultimately included 5 publications, and 217 patients constituted the cohort of the present study. In three studies, HGS was evaluated before implantation. Two studies were conducted during the postoperative course, and HGS measurements were taken before and after rehabilitation. In two studies, HGS has correlated with a significant increase of the 6-MWT passing from 300.1 to 404.8 m and 56.6 to 83.8 m, respectively. HGS in patients with LVADs ranges between (1) ca.18 and ca.33 Kg at the preoperative stage, (2) ca.24 and >40 Kg postoperatively, and (3) ca.33 and >36 Kg after having attended a postoperative rehabilitation program.

HGS appears to be a simple and reliable measure to correlate rehabilitative outcomes, such as the 6-MWT, in patients receiving or awaiting LVADs.