Elsevier

Journal of Hand Therapy

Volume 23, Issue 3, July–September 2010, Pages 272-280
Journal of Hand Therapy

Scientific/Clinical Article
Visual Feedback and Weight Reduction of a Grip Strength Dynamometer Do Not Increase Reliability in Healthy Children

https://doi.org/10.1016/j.jht.2010.01.001Get rights and content

Abstract

Study Design

Test–retest reliability study on grip strength in children.

Introduction

Measuring grip strength in children is difficult because of the weight and size of the instrument, brief attention span, and possible lack of task understanding. Therefore, adaptations to the measurement protocols to improve reliability would be very important for research and clinical evaluation.

Purpose

In this study, we compared the reliability of a grip strength dynamometer (Lode dynamometer, Lode BV, Groningen, The Netherlands) using three different protocols.

Methods

Test–retest reliability of the American Society of Hand Therapists protocol in 104 healthy children (4–12 years) was compared with the reliability in 63 healthy children of a visual feedback protocol and a suspension protocol reducing weight of the instrument.

Results

For the total group, intraclass correlation coefficients for the dominant and nondominant hands were 0.95–0.97 for all protocols, indicating that all three protocols were reliable.

Conclusion

No statistically significant difference was found among the reliability of the different protocols, but the suspension protocol produced small but significantly higher force levels.

Level of Evidence

Not applicable.

Section snippets

Subjects

After this study had been approved by the Ethical Committee of the Erasmus MC, University Medical Center and the parents of potential subjects had provided informed consent, local primary school children without upper limb impairment were approached for participation. Hand dominance and upper extremity problems that could influence hand strength were determined by evaluating parents' responses to a custom-made questionnaire on the parents' opinion of their child's hand dominance and on the

Results

The visual feedback protocol had an ICC of 0.97 for the dominant hand and 0.96 for the nondominant hand. The suspension protocol had ICCs of 0.96 for both the dominant hand and the nondominant hand. These data are similar to previously reported ICCs of 0.96 for the dominant hand and 0.95 for the nondominant hand in children.9 ICCs for different age groups and protocols are shown in Table 1. For all three protocols, the normalized SDD ranged from 19% to 27% for the total population.

When we

Discussion

The first aim of this study was to compare the reliability of three different measurement protocols in children using a grip strength dynamometer. The second aim was to study the effect of these protocols on maximum strength. The grip strength dynamometer was found to be reliable in these children: the ICC was 0.95 or higher, and the normalized SDD showed values ranging between 19% and 27% regardless of the measurement method. We found no clear effect of age on the ICCs, although the ICCs of

Conclusion

Overall, each protocol for using the grip strength dynamometer was equally reliable to use in children from 4 years and older. When the weight of the instrument was relieved in the suspension protocol, the force was significantly higher (10%). However, because there were no statistically significant differences in reliability among the three protocols, practical factors may dictate the most appropriate protocol to be used. From a practical point of view, the ASHT protocol is the most simple of

Acknowledgments

We would like to express gratitude to Eric Teunisse, director of the Montessori School in Kralingen (MSK) (Rotterdam, The Netherlands) for his cooperation during our measurements. In addition, we would like to thank all teachers and children of the MSK.

Furthermore we would like to thank “Stichting Nuts Ohra” for providing us with the necessary funds. Stichting Nuts Ohra (http://www.fondsnutsohra.nl) funded this study but had no influence on, or professional interest in, the design and outcome.

Quiz: Article # 162

Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go toJHTReadforCredit.com. There is only one best answer for each question.

  • #1.

    Hand dominance was determined by

    • a.

      direct observation of ADL

    • b.

      asking the subjects

    • c.

      parental interview

    • d.

      an initial right vs. left grip test

  • #2.

    The primary purpose of the study was to

    • a.

      compare the reliability of 3 grip testing protocols

    • b.

      determine if test scores improved by suspending the

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      Newer technological instruments now available in clinics differ from the original Jamar™ dynamometer instrument in that they produce digital output scores that enable the subject to visually monitor output during testing.24–30

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