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Test-retest intra-rater reliability of grip force in patients with stroke
Örebro University, Department of Clinical Medicine.
Uppsala universitet.
2003 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, Vol. 35, no 4, 189-194 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Coefficients of repeatability and reproducibility can be guides in differentiating between real changes and measurement error. The aim was to evaluate test-retest intra-rater reliability of a clinical procedure measuring grip force with Grippit in stroke patients, to assess relationship between grip force of the hands and between sustained and peak grip force. PATIENTS AND METHODS: Eighteen patients were tested using the Grippit at two occasions one hour apart. Each occasion comprised three consecutive trials per hand. RESULTS: The paretic hand needs to score a 50 N change within and between occasions to exceed the measurement error in 95% of the observations, irrespective of calculation method. Expressed by CV(within) the measurement error was 10%. There was no learning or fatigue effect during measuring. There was a wide variation between subjects but the mean ratio between sides was 0.66. The mean ratio between sustained and peak grip force was 0.80-0.84. CONCLUSION: The measurement errors were acceptable and the instrument can be recommended for the use in stroke patients at a department of rehabilitation medicine.

Place, publisher, year, edition, pages
2003. Vol. 35, no 4, 189-194 p.
National Category
Physiotherapy Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-7195PubMedID: 12892246OAI: oai:DiVA.org:oru-7195DiVA: diva2:222556
Available from: 2009-06-09 Created: 2009-06-09 Last updated: 2011-05-11Bibliographically approved
In thesis
1. Forced use on arm function after stroke: clinically rated and self-reported outcome and measurement during the sub-acute phase
Open this publication in new window or tab >>Forced use on arm function after stroke: clinically rated and self-reported outcome and measurement during the sub-acute phase
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
”Forced use” för armfunktion efter stroke : kliniskt bedömda och självrapporterade resultat samt mätmetoder i subakut fas
Abstract [en]

The overall aim was to evaluate the effectiveness of forced use on arm and hand recovery after stroke by applying a restraining sling on the non-affected arm and to investigate psychometric properties of selected upper limb measures.

Papers I and II reported a randomised trial with 1- and 3-month follow-ups. Thirty patients 1 to 6 months after stroke were included and received regular training for 2 weeks of intervention. The forced-use group had in addition a restraining sling on the non-paretic arm. Outcome measures were the Fugl-Meyer Assessment, the Modified Ashworth scale, the 16-hole peg test, grip force, the Action Research Arm test, and the Motor Assessment Scale (Paper I), and the Motor Activity Log (MAL) (Paper II). Results in Papers I and II showed no statistical difference in change between groups. Both groups improved over time.

Paper III assessed the responsiveness of the MAL and its cross-sectional and longitudinal validity. The MAL was responsive to change, with Standardised Response Means and Responsiveness Ratios larger than 1.0. Correlations between the MAL and the other measures were mostly close to 0.50.

Paper IV investigated test–retest intra-rater reliability of measuring grip force with Grippit, and assessed relationships between grip forces of both hands, and between sustained and peak grip force. The paretic hand needs to score a change of 10% or 50 N to exceed the measurement error. The mean ratio between sides was 0.66, and between sustained and peak grip force, 0.80–0.84.

In conclusion, this thesis provides preliminary evidence that forced use does not generate greater improvement on upper limb motor impairment, capacity, and performance of activity than regular rehabilitation. The findings indicate that the MAL is a responsive measure of daily hand use in patients with stroke. Correlations of construct validity indicated that daily hand use might need to be measured separately from body function and activity capacity. The coefficients calculated for repeatability and reproducibility were acceptable, and the Grippit instrument can be recommended.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2010. 101 p.
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 39
Keyword
stroke, upper limb, reliability, validity, ICF, forced use, motor function, effectiveness, rehabilitation, physiotherapy, grip force
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-9601 (URN)978-91-7668-715-4 (ISBN)
Public defence
2010-03-19, Wilandersalen, Universitetssjukhuset Örebro, M-huset, Örebro, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2010-02-09 Created: 2010-02-04 Last updated: 2013-05-16Bibliographically approved

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