Comparison Between Handgrip Dynamometry and Manual Muscle Testing Performed by Registered Dietitians in Measuring Muscle Strength and Function of Hospitalized Patients

Abstract

Background: The Academy of Nutrition and Dietetics and American Society the Parenteral and Enteral Nutrition (ASPEN) Consensus Statement recommends a standardized set of diagnostic characteristics to identify adult malnutrition. Due to lack of a consensus definition and challenges with measurements, physical function or performance has traditionally been difficult to assess. The purpose of this study was to determine whether manual muscle testing (MMT) performed by registered dietitians (RDs) can be used as a surrogate measurement of muscle strength and function in hospitalized patients. Method: Patients admitted to the heart failure service on the cardiac stepdown units at the Cleveland Clinic Main Campus in Cleveland, Ohio, were eligible for the study, and those who met the inclusion criteria underwent handgrip strength (HGS) testing and evaluation of nutrition status using the Academy/ASPEN Characteristics Recommended for the Identification of Adult Malnutrition. MMT was then performed within 24 hours by a different study investigator blinded to the HGS and malnutrition assessment results. Results: It was found that HGS and MMT overall were in agreement for 84% of patients and that MMT had a high sensitivity (98%) but low specificity (13%). Conclusion: This study shows feasibility for RDs to perform MMT on patients to determine muscle strength and functioning. Future practice application may be to incorporate MMT into screening criteria for patients being evaluated for malnutrition and reserve HGS testing only for patients with an abnormal MMT.

Keywords

adult life cycle nutrition assessment nutrition functional assessment malnutrition

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References

White

Guenter

Jensen

. Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). JPEN J Parenter Enteral Nutr. 2012;36(3):275-283.

Karnofsky

Burchenal

. The clinical evaluation of chemotherapeutic agents in cancer. In: MacLeod

, ed. Evaluation of Chemotherapeutic Agents. New York, NY: Columbia University Press; 1949:196.

Katz

Down

Cash

Grotz

. Progress in the development of the index of ADL. Gerontologist. 1970;10(1):20-30.

Lawton

Brody

. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179-186.

Haley

Coster

Andres

. Activity outcome measurement for postacute care. Med Care. 2004;42(1)(suppl):I49-I61.

Clarkson

. Musculoskeletal Assessment: Joint Range of Motion and Manual Muscle Strength. Philadelphia, PA: Lippincott, Williams & Wilkens; 2000.

Hislop

. Daniels and Worthingham’s Muscle Testing: Techniques of Manual Examination. 8th ed. New York, NY: Elsevier Science Health Science Division; 2007.

Fess

. Grip Strength. 2nd ed. Chicago, IL: American Society of Hand Therapists; 1992.

Bohannon

Peolsson

Massy-Westropp

. Reference values for adult grip strength measured with a Jamar dynamometer: a descriptive meta-analysis. Physiotherapy. 2006;92:11-15.

10.

National Institutes of Health (NIH). Manual Muscle Testing Procedures for MMT8 Testing. Bethesda, MD: NIH; 2011.

11.

JeVenn

DeChicco

Hipskind

. Objective structures clinical exams in a dietetic training program. Support Line. 2014;36(1):2-12.

12.

Vaz

Thangam

Prabhu

Shetty

. Maximal voluntary contraction as a functional indicator of adult chronic undernutrition. Br J Nutr. 1996;76:9-15.

13.

Bohannon

Corrigan

. A broad range of forces is encompassed by the maximum manual muscle test grade of five. Percept Motor Skills. 2000;90(3, pt 1):747-750.

14.

Klidjian

Foster

Kammerling

Cooper

Karran

. Relation of anthropometric and dynamometric variables to serious postoperative complications. Br Med J. 1980;281:899-901.

15.

Webb

Newman

Taylor

Keogh

. Hand grip dynamometry as a predictor of postoperative complications reappraisal using age standardized grip strengths. JPEN J Parenter Enteral Nutr. 1989;13:30-33.

16.

Flood

Chung

Parker

. The use of hand grip strength as a predictor of nutrition status in hospital patients. Clin Nutr. 2014;33:106-114.

17.

Norman

Kirchner

Freudenreich

. Three month intervention with protein and energy rich supplements improve muscle function and quality of life in malnourished patients with non-neoplastic gastrointestinal disease—a randomized controlled trial. J Clin Nutr. 2008;27:48-56.

18.

Mathiowetz

Kashman

Volland

Weber

Dowe

Rogers

. Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil. 1985;66:69-74.

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