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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
  1. EMG electromyography, LOS length of stay, HHD handheld dynamometer, HG handgrip, ICU intense care unit, ICUAW intense care unit-acquired weakness, MV mechanical ventilation, NO no ICUAW, SBT spontaneous breathing trial; (II), (III), (IV): Score acute physiology and chronic health evaluation II, III, IV; SAPS: Simplified acute physiology scores II, III. Median values are underlined