Artigo - Test-retest reliability of the MicroFET 4 hand-grip dynamometer

Test-retest reliability of the MicroFET 4 hand-grip dynamometer Richard W. Bohannon, EdD, PT, NCS Department of Physical Therapy, School of Allied Health, University of Connecticut, Storrs, CT 06269 \ue001 2101, USA This study was conducted to determine the test-retest reliability of measurem ents of grip strength obtained with the MicroFET 4 dynamometer. Measurements did not differ significantly between days and had high intraclass correlation coefficien ts ( > .970). The technical error of measurement was low ( \ue002 22.7 newtons). On the basis of results from this conveni ence sample of nondisabled adults, it would appear that measurements obtained with the MicroFET 4 possess high test-retest reliabil ity. Introduction Grip strength is often measur ed and for good reason. It is predictive of multiple important outcomes (Bohannon, 2001). Researchers have documented good to excellent test -retest reliability coefficients (Cicchetti, 1994) for measurements of grip stre ngth obtained with different dynamometers (Haward and Griffin, 2002; Trossman, Suleski, and Li, 1990; Balogun, Akomolafe, and Amusa, 1990; Steph ens, Pratt, and Michlovitz, 1996). Test-retest reli ability of grip strength measures obtained with the Micro- FET 4, a relatively new hand-grip dynamometer, has not been reported. Because instrument ation is a potential source of variance when measur e- ments are taken repeatedly, the test-re test reliability of measurement s obtained with the MicroFET 4 must be established before the dynamometer can be advocated for clini cal application. The purpose of this technical note, therefore, is to describe the test-retest reliability of measures of grip strength obtaine d with a MicroFET 4 dynamometer. Methods Subjects Thirty apparently healthy volunteers (16 women, 14 men) participated after signing a con- sent form approved by the university\u2019s insti- tutional review boa rd. By self-report, 26 (86.7 % ) were right -handed and 4 (13.3 % ) wer e left-handed, the mean \ue003 standard deviation (range) of their age was 38.0 \ue003 15.6 (20 \ue001 76) years, and the mean \ue003 standard deviat ion (range) of their weight was 727.6 \ue003 131.2 (498.1 \ue001 934.0) newtons. Instrumentation and procedures A Micr oFET 4 han d-g rip dy namome ter (H og- gan Heal th Industr ies, West Jord an, UT), whic h digi ta lly di splays f orce s to th e near est pound , was used to me asure grip st rength (F igur e 1). The ac cura cy of th e dynam ometer wa s chec ked peri odi ca lly th ro ugh out th e study an d con firm ed each day b y comp arison to a kno wn st and ard . Accepted for publication 2 June 2005. Address correspondence to Richard W. Bohannon, EdD, PT, NCS, Department of Physical Therapy, Neag School of Education, University of Connecticut, Storrs, CT 06269-2101, USA. E-mail: richard.bohannon@uconn.edu Physiotherapy Theory and Practice , 22(4):219 \ue001 221, 2006 Copyright # Informa Healthcare ISSN: 0959-3985 print/1532-5040 online DOI: 10.1080/09593980600822875 219 In ac cordance with the recommend ations of the American Society of Hand Therapists (Fess, 1992), subjects were tested while seated with their shoulders adducted, their elbows flexed 90 \ue004 , and their forearms in neutral rotation. Sub- jects were asked to \u2018\u2018squeeze as hard as possible\u2019\u2019 and were given consistent verbal encouragem ent to squeeze \u2018\u2018harder, harder, ha rder\u2019\u2019 during a 4.0 \ue001 5.0-second effort. Tes ting took place within several hours of the same tim e on 2 consecuti ve days. By random assignment , 16 subject s wer e tested first of their right side and 14 were tested first on their left side. Two trials were allowed on each side with a 30-second rest between trials. The subjects wer e blind to their results until after they had completed both days of testing. A single tester recorded both day\u2019s measures but recorded those of the second day without refer - ence to those of the 1st day. Data analysis All analysis was co nducted by using the Statistical Program for the Social Sciences (SPSS 11.0). The grip forces wer e converted to newtons and the first, best, and mean of each day\u2019s two trials on each side were used to compare measurements between days. Standard descrip- tive statistics were calcul ated for grip forces. Test-retest reliability of the measures was described by using paired t-tests, intraclass cor- relation coefficients (ICC s [3,1]), and the techni- cal error of measurement (Engstrom, 1988). Results Table 1 summarizes all statist ical analysis. There was no significant diff erence in the forces between days. Using the crit eria of Cicchetti (1994), the reliability coefficients can be con- sidered excell ent ( ICC ¼ 0.974 \ue001 0 .985). The technical error of measurement was small (17.8 \ue001 22.7 newtons). Discussion The results of this study show that measure- ments obtaine d with the MicroFET 4 dyna- mometer possess excellent reliability and are at least as reliable as those that have been acquired by others with different makes of hand-grip dynamometers (Haw ard and Griffin, 2002; Trossman, Suleski, and Li, 1990; Balogun, Ako - molafe, and Amusa, 1990; Stephens, Pratt, and Michlovitz, 1996). Practically, this means that the MicroFET 4 can be used in research and clinical settings to document changes in grip strength that occur over tim e. The technical error of measurement provides an indica tion of the magnitude of ch ange that needs to occur before a change should be considered real. The favorable findings of this study have several limitations. First, it was conducted on apparently healthy, nondisabled subject s. Although the reliability established by using such a sample is informative, it may differ some- what from that demonstrated by individu als with other characteristics. Therefor e, generaliza- tion to other groups (e.g., elderly patients) should be pursued with caution. Second , the present study involved a relative ly small sample. Although this can be problem atic, it did not pre- clude the demonstration of ICCs wi th confi- dence inter vals well within the excellent range ( > 0.900). Third, the test-re test interval was short. Such a lim ited intertest interval may be accompanied by great er reliab ility than would be realized if a longer hiatus (e.g., 1 week or 1 month) occurred between tests. Figure 1. Testing of hand strength with a MicroFET 4 hand-grip dynamometer. 220 Bohannon/Physiotherapy Theory and Practice 22 (2006) 219 \ue001 221 The limitations of this study provide initial support for the test-retest reliability of measure- ments obtained with the M icroFET 4. Future research should focus on patie nts tested in clini- cal settings. References Balogun JA, Akomolafe CT, Amusa LO 1990 Reproduci- bility and criterion-related validity of modified sphygmo- manometer for isometric testing of grip strength. Physiotherapy Canada 42: 290 \ue001 295 Bohannon RW 2001 Dynamometer measurements of hand- grip strength predict multiple outcomes. Perceptual and Motor Skills 93: 323 \ue001 328 Cicchetti DV 1994 Guidelines, criteria, and rules of thumb for evaluating normed and standardized instruments in psychology. Psychological Assessment 6: 284 \ue001 290 Engstrom JL 1988 Assessment of the reliability of physical measures. Research in Nursing and Health 11: 383 \ue001 389 Fess EE 1992 Grip strength. In: Casanova JS (ed), Clinical assessment recommendations, 2nd ed, pp 41 \ue001 45. Chi- cago, IL, American Society of Hand Therapists Haward BM, Griffin MJ 2002 Repeatability of grip strength and dexterity tests and the effects of age and gender. International Archives of Occupational and Environmen- tal Health 75: 111 \ue001 119 Stephens JL, Pratt N, Michlovitz S 1996 The reliability and validity of the Tekdyne hand dynamometer. Part II. Jour- nal of Hand Therapy 9: 18 \ue001 26 Trossman PB, Suleski KB, Li P-W 1990 Test-retest reliability and day-to-day variability of an isometric grip strength test using the work simulator. Occupation al Therapy Journal of Research 10: 266 \ue001 279 Table 1. Statistics describing the test-retest reliability of measurement s obtained with a MicroFET 4 dynamometer. Measure Day 1 \ue002 Day 2 \ue002 T test ICC (95 % CI) TEM \ue002 mean \ue003 SD (min \ue001 max) mean \ue003 SD (min \ue001 max) T value ( p ) First (left) 407.5 \ue003 138.3 (235.7 \ue001 653.8) 400.7 \ue003 146.8 (213.5 \ue001 671.6) 1.006 (0.323) 0.974 (0.947 \ue001 0.987) 22.7 Best (left) 413.6 \ue003 138.3 (249.1 \ue001 653.8) 410.1 \ue003 144.5 (231.3 \ue001 671.6) 0.704 (0.487) 0.981 (0.960 \ue001 0.991) 19.6 Mean (left) 402.9 \ue003 135.2 (246.8 \ue001 674.1) 400.7 \ue003 144.5 (222.4 \ue001 684.9) 0.390 (0.700) 0.980 (0.958 \ue001 0.990) 19.6 First (right) 428.7 \ue003 149.9 (186.8 \ue001 729.4) 424.7 \ue003 158.8 (151.2 \ue001 729.4) 0.676 (0.505) 0.979 (0.957 \ue001 0.990) 22.7 Best (right) 432.7 \ue003 150.3 (209.0 \ue001 739.2) 434.5 \ue003 157.9 (209.0 \ue001 747.2) \ue001 0.389 (0.700) 0.985 (0.969 \ue001 0.993) 17.8 Mean (right) 423.4 \ue003 150.8 (197.9 \ue001 734.3) 424.7 \ue003 155.7 (180.1 \ue001 738.3) \ue001 0.278 (0.783) 0.984 (0.966 \ue001 0.992) 19.1 \ue002 Measures are presented in newtons. Bohannon/Physiotherapy Theory and Practice 22 (2006) 219 \ue001 221 221

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