HHD Measurement for Muscle Strength in Stroke Patients

Overseen By Cathey Norton

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Vanderbilt University Medical Center

Disqualifiers: Contractures, Vital signs, Symptoms, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 1

20 Participants Needed

Trial Summary

What is the purpose of this trial?

This study wants to know if using handheld dynamometry (HHD) to test leg strength in persons who have had a stroke, will reduce mistakes and give therapists better information to use for therapy. This study will collect normal values of leg muscle peak force production, cumulative peak force production, and sustained peak force production in patients with chronic stroke.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Hand-held Dynamometry for muscle strength in stroke patients?

Research shows that hand-held dynamometry is a reliable tool for measuring muscle strength in stroke patients, as it provides objective data on strength deficits and improvements over time. This tool is considered the gold standard for assessing muscle strength, which helps clinicians make informed decisions about patient care. ^{1 2 3 4 5}

Is using a hand-held dynamometer safe for measuring muscle strength in stroke patients?

The research does not provide specific safety information about using hand-held dynamometers for measuring muscle strength in stroke patients, but these devices are generally used as a standard tool for assessing muscle strength, suggesting they are considered safe for this purpose. ^{1 2 4 5 6}

How does the hand-held dynamometry treatment differ from other treatments for measuring muscle strength in stroke patients?

Hand-held dynamometry (HHD) is unique because it provides a quick, low-cost, and reliable way to measure muscle strength, which is particularly useful for stroke patients who may have muscle weakness. Unlike other methods, HHD is portable and can be used easily in various settings, making it more accessible for regular monitoring of muscle strength. ^{7 8 9 10 11}

Eligibility Criteria

This trial is for adults over 18 who've had a stroke at least 3 months ago and can follow simple commands. They must be able to hold certain positions like sitting or lying down during tests. People with severe limb stiffness, unstable vital signs, symptoms like shortness of breath or dizziness, active infections at the test site, or other serious health issues affecting physical activity cannot join.

Inclusion Criteria

I can understand and follow two-step instructions.

I am 18 years old or older.

I had a stroke more than 3 months ago.

Exclusion Criteria

Your resting heart rate, blood pressure, or oxygen level is not suitable for exercise.

You have other health conditions that would make it difficult for you to take part in physical activities.

I have an infection or injury where the test will be done.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Assessment

Assessment of isometric muscle strength and power using the Activbody Activ5 device

1 session

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after assessment

1 year

Treatment Details

Interventions

• Hand-held Dynamometry

Trial Overview The study is testing if hand-held dynamometry (HHD), a tool for measuring muscle strength in the legs, can provide accurate data for therapists treating patients with chronic stroke. It will measure normal values of leg muscle force in different ways to see how well it works.

Participant Groups

Group I: Average Force Production Experimental Treatment 1 Intervention

Average force production of bilateral lower extremities will be collected using the handheld dynamometer, Activbody Activ5.

Who Is Running the Clinical Trial?

Vanderbilt University Medical Center

Lead Sponsor

Trials

922

Recruited

939,000+

Findings from Research

The study evaluated the reliability of muscle strength measurements in the upper extremity of 45 individuals with mild to moderate paresis post-stroke, finding high reliability (ICCs between 0.92 and 0.97) for both isometric and isokinetic strength assessments.

Isometric strength measurements showed smaller measurement errors compared to isokinetic measurements, suggesting that isometric tests may be preferred for assessing muscle strength in chronic stroke patients, depending on the specific research needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Isometric and isokinetic muscle strength in the upper extremity can be reliably measured in persons with chronic stroke. Ekstrand, E., Lexell, J., Brogårdh, C.[2018]

The study found that portable dynamometers are reliable for measuring hand grip, pinch grip, and trunk strength in individuals with subacute stroke, showing high intra-rater and inter-rater reliability (ICC values between 0.64 and 0.99).

Using just one trial after familiarization yielded low standard error of measurement (SEM) and minimal detectable difference (MDD95%), indicating that this method is both effective and efficient for assessing muscle strength in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dynamometry for the measurement of grip, pinch, and trunk muscles strength in subjects with subacute stroke: reliability and different number of trials. Aguiar, LT., Martins, JC., Lara, EM., et al.[2022]

In a study of hemiplegic stroke patients (n = 24 to 58), initial strength assessments were found to be strong predictors of strength recovery by discharge, indicating that early evaluations can guide treatment plans.

The research highlights significant upper extremity strength deficits in stroke patients, emphasizing the need for targeted rehabilitation strategies based on initial strength measurements.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Upper extremity strength deficits in hemiplegic stroke patients: relationship between admission and discharge assessment and time since onset. Bohannon, RW., Smith, MB.[2006]

A new index of muscle strength for stroke patients was developed, based on a study of 63 individuals who were 3 to 12 months post-stroke, using hand-held dynamometry to assess lower-extremity muscle strength in various positions.

The study found that muscle strength on the affected side was about 85% of the unaffected side in gravity-related positions and 92% in gravity-eliminated positions, indicating significant but variable recovery of strength post-stroke.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development of a position-specific index of muscle strength to be used in stroke evaluation. Moriello, C., Mayo, NE.[2007]

In a study of 26 stroke patients, three simple measures of upper limb strength showed significant correlations with objective dynamometer measurements, indicating they can be useful for assessing strength.

Despite some patients scoring well on the NIH Stroke Scale for arm function, they reported low strength levels, suggesting that these simple measures may not accurately reflect mild to moderate weakness in upper limbs after a stroke.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adequacy of simple measures for characterizing impairment in upper limb strength following stroke. Bohannon, RW.[2007]

MyotonPRO showed good reliability in measuring muscle mechanical properties in acute stroke patients, with intraclass correlation coefficients (ICCs) ranging from 0.63 to 0.97 across different muscles.

While MyotonPRO can be used effectively in a clinical setting, the variability in results between different muscles and measurement parameters suggests that caution is needed when interpreting the data.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Relative and Absolute Interrater Reliabilities of a Hand-Held Myotonometer to Quantify Mechanical Muscle Properties in Patients with Acute Stroke in an Inpatient Ward. Lo, WLA., Zhao, JL., Li, L., et al.[2022]

Hand-held dynamometry (HHD) demonstrated high reliability for measuring lower extremity strength in young, healthy subjects, with intratester reliability showing an ICC range of .77 to .97.

While HHD is a reliable tool, its effectiveness may be limited for certain movements where subjects can exert more force than the testers, indicating a need for careful application in strength assessments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Hand-held dynamometry: reliability of lower extremity muscle testing in healthy, physically active,young adults. Kelln, BM., McKeon, PO., Gontkof, LM., et al.[2022]

The study confirmed that using a hand-held dynamometer (HHD) to measure quadriceps strength in hemiplegic patients is both valid and reliable, showing a strong correlation (0.99) with the gold standard KIN-COM measurements.

Standardized procedures for measurement were crucial, as significant differences in strength were found based on the measurement position and setup, but not among different examiners or trials, indicating consistency in the method.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Validity and reliability of the measurement of the quardriceps femoris muscle strength with a hand-held dynamometer on the affected side in hemiplegic patients. Piao, C., Yoshimoto, N., Shitama, H., et al.[2019]

Handheld dynamometers (HHD) have been found to be a valid tool for measuring scapular protraction muscle strength in various groups, including athletes and individuals with shoulder instability, based on a study involving 60 participants across three groups.

The study showed a strong correlation between HHD measurements and isokinetic dynamometer measurements, particularly in a seated position, although HHD may overestimate peak force compared to the isokinetic standard.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Concurrent validity of handheld dynamometer measurements for scapular protraction strength. Liberatori Junior, RM., Netto, WA., Carvalho, GF., et al.[2020]

The study found that hand-held dynamometry (HHD) has high relative reliability for measuring knee strength, with intra-observer reliability scores (ICC) of 0.94 and 0.86 for different measurement methods, indicating consistent results from the same examiner.

Measurement errors were modest, with the smallest detectable differences (SDD) ranging from 17.23 Nm to 31.62 Nm, suggesting that HHD can effectively detect meaningful changes in knee extension strength in individual patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Hand-held dynamometry in patients with haematological malignancies: measurement error in the clinical assessment of knee extension strength. Knols, RH., Aufdemkampe, G., de Bruin, ED., et al.[2021]

The Handheld Dynamometer (HHD) demonstrated high reliability for measuring knee extension strength in a study of 29 rehabilitation patients, with intra-rater reliability showing an Intraclass Correlation Coefficient (ICC) of 0.978 when averaging two measurements.

Both experienced and inexperienced physicians achieved similar reliability results, indicating that HHD can be effectively used by various practitioners, especially when two measurements are taken to enhance accuracy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Handheld dynamometer reliability to measure knee extension strength in rehabilitation patients-A cross-sectional study. Pinto-Ramos, J., Moreira, T., Costa, F., et al.[2022]

References

1. Sweden pubmed.ncbi.nlm.nih.gov

Isometric and isokinetic muscle strength in the upper extremity can be reliably measured in persons with chronic stroke. [2018]

2. Brazil pubmed.ncbi.nlm.nih.gov

Dynamometry for the measurement of grip, pinch, and trunk muscles strength in subjects with subacute stroke: reliability and different number of trials. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Upper extremity strength deficits in hemiplegic stroke patients: relationship between admission and discharge assessment and time since onset. [2006]

4. United States pubmed.ncbi.nlm.nih.gov

Development of a position-specific index of muscle strength to be used in stroke evaluation. [2007]

5. United States pubmed.ncbi.nlm.nih.gov

Adequacy of simple measures for characterizing impairment in upper limb strength following stroke. [2007]

6. United States pubmed.ncbi.nlm.nih.gov

Relative and Absolute Interrater Reliabilities of a Hand-Held Myotonometer to Quantify Mechanical Muscle Properties in Patients with Acute Stroke in an Inpatient Ward. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Hand-held dynamometry: reliability of lower extremity muscle testing in healthy, physically active,young adults. [2022]

8. Japan pubmed.ncbi.nlm.nih.gov

Validity and reliability of the measurement of the quardriceps femoris muscle strength with a hand-held dynamometer on the affected side in hemiplegic patients. [2019]

9. Brazil pubmed.ncbi.nlm.nih.gov

Concurrent validity of handheld dynamometer measurements for scapular protraction strength. [2020]

10. England pubmed.ncbi.nlm.nih.gov

Hand-held dynamometry in patients with haematological malignancies: measurement error in the clinical assessment of knee extension strength. [2021]

11. United States pubmed.ncbi.nlm.nih.gov

Handheld dynamometer reliability to measure knee extension strength in rehabilitation patients-A cross-sectional study. [2022]