Author: Fung, Yim-kwan
Title: Validity and reliability of the grip tool of the Baltimore therapeutic equipment primus in different body positions of healthy subjects
Degree: M.Sc.
Year: 2006
Subject: Hong Kong Polytechnic University -- Dissertations.
Occupational therapy -- Equipment and supplies.
Physical therapy -- Equipment and supplies.
Grip strength -- Measurement.
Department: Department of Rehabilitation Sciences
Pages: xiii, 82 leaves : ill. (some col.) ; 30 cm.
Language: English
Abstract: Measurement of handgrip strength by Jamar dynamometer is commonly performed by physiotherapists to measure baseline deficiency in hand muscle strength, to monitor progress during rehabilitation, and to document outcome after rehabilitation. The handgrip tool of the Baltimore Therapeutic Equipment (BTE) Primus (BTE Co, Hanover, MD) is a computerized instrument designed to measure static grip strength. Recently, there is a growing trend of using the BTE Primus by physiotherapists for grip strength measurement in various clinical settings. Since this is a newly designed instrument for grip strength measurement and the standardized testing position is not the same as the standardized testing position of the Jamar dynamometer. It is necessary to examine the validity and reliability of the grip tool of the BTE Primus. Moreover, there are controversies in the literature regarding which elbow position (90o flexion and fully extended elbow) and which body position (sitting and standing) can obtain maximum grip strength. Thus the purposes of this study were to investigate the criterion-related validity of the grip tool of the BTE Primus, to examine the repeated measure reliability of the grip strength within each subject and to examine the reliability of the BTE grip tool in 4 different body and elbow positions, combining either standing or sitting with extended or flexed elbow. Thirty healthy subjects (18 males and 12 females) with mean age of 38.4 (+- 10.4) participated in the study. Maximum grip strength of the dominant hands were obtained using the Jamar dynamometer in the standardized position recommended by the American Society of Hand Therapists (ASHT) and the attachment #162 of the grip tool of the BTE Primus in 4 different positions (Position A, B, C and D). Pearson correlation coefficient, intraclass correlation coefficient (ICC(3,1)) and Limits of Agreement (LoA) with Bland and Altman plot were computed. The results confirmed the expected criterion-related validity, repeated trials reliability of the grip strength within each subject and reliability of BTE Primus grip tool across 4 different body positions. The Pearson correlation coefficient between the Jamar dynamometer and the BTE grip tool was 0.991. The mean difference between these two equipment was -0.05 kg and the LoA with 95% CI was -3.10 kg to 3.00 kg. The ICC of the 3 trials repeated measures reliability ranged from 0.983 to 0.995. The reliability of the BTE grip tool in 4 difference positions was excellent with the ICC (3,1) exceeding 0.9. These results implied that the grip tool of the BTE Primus is a reliable instrument to measure handgrip strength. In addition, obtaining grip strength using the mean of 3 trials with the grip tool of the BTE Primus is a reliable method to obtain a maximum grip strength score. Besides, the grip score that is obtained by this instrument is not affected by body and elbow positions. In conclusion, the grip tool of the BTE Primus is a valid and reliable instrument to measure the static grip strength of the dominant hand in healthy subjects. However, future studies with larger sample size per age and gender group and subjects with upper limb injuries are highly recommended.
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