Table 3 Main outcomes from studies measuring voluntary force with handheld (HHD) and handgrip (HG) dynamometers in ICU patients
From: Bedside voluntary and evoked forces evaluation in intensive care unit patients: a narrative review
References | Number of patients | % Men | Age (years) | Ventilation duration (days) | ICU LOS (days) | Disease severity | Scoring system | Method | Testing session (days) | Main results |
|---|---|---|---|---|---|---|---|---|---|---|
Ali et al. [10] | 35 with ICUAW 101without ICUAW | 40 50.5 | 59.5 57.1 | 12 6 | 21 12 | 66 | APACHE III | HG (seated) | N/A | Handgrip cutoffs values for ICUAW diagnostic: 7 kg for women, 11 kg for men |
Vanpee et al. [11] | 39 + 12 (retest) | 62 | 64 | N/A | N/A | N/A | N/A | HHD | N/A | Absolute force for shoulder abduction: 74 N; elbow flexion: 75–79 N; wrist extension: 61–62 N; hip flexion: 112–119 N; knee extension: 85–94 N; ankle dorsiflexion: 57–80 N No gender difference for force loss |
Hermans et al. [19] | 46 | 59 | N/A | N/A | 15 | N/A | N/A | HG (seated) | 15 | HG absolute force for right hand: 11 kg for women vs 19 kg for men |
Parry et al. [24] | 60 | 58 | 69 | 6.6 | 12 | 22 | APACHE II | HG (supine) | 9 | HG absolute median force values were 20 kg and 0 kg in men and women, respectively 27% of patients had a grip force of 0 kg (majority of women with n = 14/16) |
Schmidt et al. [27] | 28 with ICUAW 22 without ICUAW | 39 50 | 58 49 | N/A | 40 14 | 77 66 | APACHE IV | HG (seated) | N/A | Definition of new HG cutoff values (4 kg and 7 kg in women and men, respectively) to diagnose ICUAW as compared with EMG measurements HG absolute force values were lower in patients with ICUAW as compared with patients without ICUAW (2.5 vs 13.6 kg, respectively) |
Cottereau et al. [32] | 3 groups: 41 33 10 | 37 60 10 | 58 68 69 | 4 11 20 | 8 17 24 | 47 52 60 | SAPS II | HG (seated) | First SBT: 4 8 12 | Absolute HG force values were of 20; 12 and 6 kg at day 4; 8, and 12 of SBT, respectively Relative HG force values were of 30; 29 and 25% at day 4; 8, and 12 of SBT, respectively (normative database of Bohannon et al. [48]) |
Borges et al. [33] | 72 | 36 | 53 | 7.5 | 10 | 20 | APACHE II | HHD (quadriceps) + HG (seated) | Hospital discharge | Quadriceps and HG relative values were: 51% and 55% (Normative database of Hogrel et al. [65]) |
Bragança et al. [34] | 45 | 60 | 55 | 5 | 10 | 69 | SAPS III | HG (seated) | N/A | ICUAW patients had lower HG absolute force values as compared with patients without ICUAW (4 vs 22 kg, respectively) HG cutoff values [10] had high agreement with MRC criteria for ICUAW diagnosis |
Sidiras et al. [35] | 36 with ICUAW 92 without ICUAW | 42 74 | 58 51 | 18 08 | 26 12 | 18 15 | APACHE II | HG (seated) | ICU and hospital discharge | ICUAW patients are weaker than patients without ICUAW at both ICU and hospital discharge (3 vs 14 kg and 7 vs 16 kg, respectively) Women had lower HG relative force values at ICU and hospital discharge as compared with men |
Borges & Soriano [36] | 37 | 54 | 53 | 5 | 10 | 56 | SAPS III | HG (seated) | 3 and hospital discharge | HG absolute force values were of 12 and 19 kg at day 3 and hospital discharge, respectively HG relative values were of 37% vs 68% at day 3 and hospital discharge, respectively (normative database of Günther et al. [46] |
Burtin et al. [38] | 90 | 72 | 57 | N/A | N/A | 25 | APACHE II | HHD + HG (supine) | ICU and hospital discharge | No significant difference for quadriceps force (normalized to body weight) measured with HHD between ICU and hospital discharge: 1.86 N.kg−1 and 2.03 N.kg−1 |
Baldwin et al. [39] | 17 | 59 | 78 | 10 | 18 | 20 | APACHE II | HHD + HG (supine) | 13 | HG, elbow flexion and knee extension absolute force values for right side were: 11; 9 and 11 kg, respectively |
Baldwin & Bersten [40] | 16 | 56 | 62 | 13 | 20 | 94 | APACHE III | HHD + HG (supine) | 16 | HG, elbow flexion and knee extension absolute force values for right side were 11; 9 and 8 kg, respectively |
Chlan et al. [41] | 120 | 49 | 52 | N/A | N/A | 61 | APACHE III | HG (supine) | 9 (still ventilated) | Mean HG force was 3.2 kg (ranging from 0 to 54 kg) with 6 patients having a force of 0 kg No force improvement was observed over time under MV |
Dietrich et al. [45] | 253 | 52 50 | < 80 > 80 | 8 6.5 | 10 9 | 14 | APACHE II | HG (seated) | 1–5 after ICU discharge | HG absolute force (dominant, non-dominant): 20 and 18 kg for patients < 80 years vs 15 and 13 kg for patients > 80 years |
Samosawala et al. [49] | 64 | 64 | 49 | N/A | 9.6 | N/A | N/A | HHD | 3; 5 and 7 | Absolute force decreased by 11.8% between day 3 and 7 |
Morris et al. [50] | 300 | 45 | 56 | N/A | 7.5 | 76 | APACHE III | HHD + HG (seated) | ICU and hospital discharge | HHD and HG absolute values at ICU and hospital discharge were: 9.9 kg and 10.4 kg vs 20.9 and 24.3 kg, respectively |
Segaran et al. [51] | 44 | 78 | 58 | 4–16 | 7–16 | 20 | APACHE II | HG (seated) | N/A | HG measurements not feasible due to a lack of alertness (assessed by 4 questions), weakness and poly-trauma |