Date Presented 04/06/19
This study presents norms for the bulb dynamometer for the older adult population. The study demonstrates that the bulb dynamometer is less painful and more comfortable to use compared to the Jamar dynamometer. Regressions show that age and gender have a significant impact on grip strength.
Primary Author and Speaker: Rochelle Mendonca
Additional Authors and Speakers: Colleen Maher, Jennifer Wright, Maribeth Keith, Aaron Simon, Angeline Danan, Rachelle Aningalan, Vien Phan
PURPOSE: Hand function is an indicator of health and well-being, and correlates with an individual's ability to perform meaningful and purposeful activities1. The Jamar hydraulic hand dynamometer is a commonly used instrument for assessing hand function. Although the Jamar dynamometer is the gold standard, it is not always the best measure of grip strength for individuals with fragile or unstable hand structure, such as the elderly and individuals with rheumatoid arthritis2,3. It is hypothesized in scholarly research that the Baseline Pneumatic Squeeze Bulb Dynamometer (30 psi) (Bulb Dynamometer) may be used as an alternative for measuring grip strength2,4. However, unlike the Jamar hydraulic hand dynamometer, which has been accepted as the gold standard, there is limited evidence on established norms and usability of the bulb dynamometer. The purpose of this study was to establish norms for the bulb dynamometer for the older adult population and to evaluate differences in pain and comfort between using the bulb or the Jamar dynamometer for hand grip strength measurement.
DESIGN: A descriptive study design was used for this study. Three hundred eighty six (105-Males, 281-Females) participants aged 55 and older were recruited for the study from senior centers and 55+ communities through convenience sampling.
METHODS: Two instruments were used in this study: 1) the Baseline Bulb Pneumatic Squeeze Bulb Dynamometer that measures overall grip strength from 0 - 30 pounds per square inch (psi) and 2) the Jamar Dynamometer that measures grip strength from 0-200 pounds (lbs). Standardized use and measurement of both the bulb and Jamar dynamometer were performed as per the American Society of Hand Therapists (ASHT) guidelines. Participants were randomized to either the Jamar or the Bulb dynamometer first, followed by the second dynamometer. Both hands were tested and a 2-minute rest interval was provided between testing with the two instruments. Visual analog scales were used to measure both pain and comfort after use of the bulb and the Jamar Dynamometers. Demographic information including age, gender, ethnicity and hand dominance were collected from the participants. Data was analyzed using IBM SPSS 23.0 (Version 23; IBM Corp., Armonk, NY). Means and standard deviations were used to report norms. Paired sample t-tests were used to evaluate if there were differences in pain and comfort when using the bulb versus the Jamar dynamometer and regressions evaluated if age, gender, ethnicity and hand dominance.
RESULTS: Norms were obtained for using the bulb dynamometer for both males and females for both hands. Results showed that there were significant differences in pain and comfort when using the bulb dynamometer compared to the Jamar dynamometers (p<0.05). The bulb dynamometer was less painful (Bulb-1.37, Jamar-2.38) and more comfortable (Bulb-2.63, Jamar-4.28) to use compared to the Jamar dynamometer. Regression analyses showed that age and gender were significant predictors of hand grip strength measurement for both the Jamar and the Bulb dynamometers (p<0.05).
CONCLUSION: The results of this study suggest that the bulb dynamometer might be less painful and more comfortable to use, especially for the older adult population. The preliminary norms can be used by clinicians when using the bulb dynamometer.
IMPACT: OT and OTA practitioners utilize dynamometers to assess individuals’ grip strength and hand function. Current evidence indicates that the bulb dynamometer is a more appropriate tool to use for certain populations such as the elderly and individuals with rheumatoid arthritis. The study provides norms for the use of the bulb dynamometer and establishes that the bulb is less painful and more comfortable to use for older adults.
References
1. Lawrence, E. L., Dayanidhi, S., Fassola, I., Requejo, P., Leclercq, C., Winstein, C. J., & Francisco, V. J. (2015). Outcome measures for hand function naturally reveal three latent domains in older adults: strength, coordinated upper extremity function, and sensorimotor processing. Frontiers in Aging Neuroscience, https://doi.org/10.3389/fnagi.2015.00108
2. Fess, E. E. (2011). Functional tests. (2011). In T. M. Skirven, A. L. Osterman, J. M. Fedorczyk, & P. C. Amadio (Eds.) Rehabilitation of the Hand and Upper Extremity (55-79). Philadelphia: Elsevier-Mosby
3. Jones, E., Hanly, J., Mooney, R., Rand, L., Suprway, P., Eastwood, B., & Jones, J. (1991). Strength and function in the normal and rheumatoid hand. Journal of Rheumatology, 18(9), 1313-8.
4. Blankevoort C. G., Van Heuvelen M. J., Scherder E. J.(2013). Reliability of six physical performance tests in older people with dementia. Physical Therapy, 93(1), 69-78. doi: 10.2522/ptj.20110164
