Reliability and clinical applicability of lower limp strength using an enhanced paper grip strength

Submitted: 19 September 2023
Accepted: 19 October 2023
Published: 1 December 2023
Abstract Views: 923
PDF: 300
HTML: 4
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

The enhanced paper grip test (EGPT) quantitatively assesses lower limb strength. EGPT assesses the hallux grip force by reacting a pulling force derived from a card, being positioned underneath the participant's hallux. This study aimed to investigate the repeatability and clinical applicability of the EPGT for assessing foot muscle strength. EPGT force was measured using a dynamometer. The reliability of the measurement of EPGT force was assessed by having two examiners performing the test on the same group of healthy adults. Clinical applicability was assessed in community-dwelling adults of both genders. EPGT force was recorded for both feet using the same standardised protocol for all participants. Regarding reliability, 20 healthy adults aged 23.04±5.5 years participated in the present study. The EGPT demonstrated good to excellent test-retest (ICC1,2 0.8 to 0.86) and interrater reliability (ICC1,2 0.82 to 0.88). A convenience sample of 15 community-dwelling adults (71.6±7.8 years, 68.5% women) was recruited for clinical applicability testing. All participants performed the test with mean score 15±5.7 N. EPGT is a reliable measurement of the hallux grip force strength and can be used for clinical and research purposes.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Mickle KJ, Angin S, Crofts G, Nester CJ. Effects of Age on Strength and Morphology of Toe Flexor Muscles. J Orthop Sports Phys Ther. 2016 Dec;46(12):1065-1070. Epub 2016 Oct 29. PMID: 27796198. DOI: https://doi.org/10.2519/jospt.2016.6597
Barbat-Artigas S, Rolland Y, Zamboni M, Aubertin-Leheudre M. How to assess functional status: a new muscle quality index. J Nutr Health Aging. 2012 Jan PMID: 22238004. DOI: https://doi.org/10.1007/s12603-012-0004-5
Buckinx F, Aubertin-Leheudre M. Relevance to assess and preserve muscle strength in aging field. Prog Neuropsychopharmacol Biol Psychiatry. 2019 Aug 30;94:109663. Epub 2019 Jun 7. PMID: 31176745. DOI: https://doi.org/10.1016/j.pnpbp.2019.109663
Visser M, Deeg DJ, Lips P, Harris TB, Bouter LM. Skeletal muscle mass and muscle strength in relation to lower-extremity performance in older men and women. J Am Geriatr Soc. 2000; 2000 Apr PMID: 10798463. DOI: https://doi.org/10.1111/j.1532-5415.2000.tb04694.x
Abdalla PP, Bohn L, da Silva LSL, Dos Santos AP, Tasinafo Junior MF, Venturini ACR, Dos Santos Carvalho A, Gomez DM, Mota J, Machado DRL. Identification of muscle weakness in older adults from normalized upper and lower limbs strength: a cross-sectional study. BMC Sports Sci Med Rehabil. 2021 Dec 18; PMCID: PMC8684151 DOI: https://doi.org/10.1101/2021.07.28.21261230
Cawthon PM, Fox KM, Gandra SR, Delmonico MJ, Chiou CF, Anthony MS, Sewall A, Goodpaster B, Satterfield S, Cummings SR, Harris TB; Health, Aging and Body Composition Study. Do muscle mass, muscle density, strength, and physical function similarly influence risk of hospitalization in older adults? J Am Geriatr Soc. 2009 Aug PMID: 19682143; PMCID: PMC3269169. DOI: https://doi.org/10.1111/j.1532-5415.2009.02366.x
Clark BC, Manini TM. Sarcopenia ≠ Dynapenia. J Gerontol Ser A. 2008 Aug PMID: 18772470.
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001 Mar PMID: 11253156. DOI: https://doi.org/10.1093/gerona/56.3.M146
Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Erratum in: Age Ageing. 2019 Jul 1;48(4):601. PMID: 30312372; PMCID: PMC6322506. DOI: https://doi.org/10.1093/ageing/afz046
Pijnappels M, van der Burg PJ, Reeves ND, van Dieën JH. Identification of elderly fallers by muscle strength measures. Eur J Appl Physiol. 2008 Mar Epub 2007 Dec 11. PMID: 18071745; PMCID: PMC2226001.
Murphy SL, Williams CS, Gill TM. Characteristics associated with fear of falling and activity restriction in community-living older persons. J Am Geriatr Soc. 2002 Mar PMID: 11943049; PMCID: PMC3046411.
Chatzistergos PE, Healy A, Balasubramanian G, Sundar L, Ramachandran A, Chockalingam N. Reliability and validity of an enhanced paper grip test; A simple clinical test for assessing lower limb strength. Gait Posture. 2020 Sept Epub 2020 Jul 16. PMID: 32711330. DOI: https://doi.org/10.1016/j.gaitpost.2020.07.011
Menz HB, Zammit GV, Munteanu SE, Scott G. Plantarflexion strength of the toes: age and gender differences and evaluation of a clinical screening test. Foot Ankle Int. 2006 Dec PMID: 17207439. DOI: https://doi.org/10.1177/107110070602701217
Kwon O, Tuttle L, Johnson J, Mueller M. Muscle imbalance and reduced ankle joint motion in people with hammer toe deformity. Clin Biomech. 2009 Oct. Epub 2009 Jun 16. PMID: 19535185; PMCID: PMC2751588.
Spink MJ, Fotoohabadi MR, Menz HB. Foot and ankle strength assessment using hand-held dynamometry: reliability and age-related differences. Gerontology. 2010 Epub 2009 Dec 3. PMID: 19955706. DOI: https://doi.org/10.1159/000264655
de Win MM, Theuvenet WJ, Roche PW, de Bie RA, van Mameren H. The paper grip test for screening on intrinsic muscle paralysis in the foot of leprosy patients. Int J Lepr Other Mycobact Dis. 2002 Mar PMID: 12120036
Bruening DA, Ridge ST, Jacobs JL, Olsen MT, Griffin DW, Ferguson DH, Bassett KE, Johnson AW. Functional assessments of foot strength: a comparative and repeatability study. BMC Musculoskelet Disord. 2019 PMID: 31837710; PMCID: PMC6911702. DOI: https://doi.org/10.1186/s12891-019-2981-6
Deyo RA, Diehr P, Patrick DL. Reproducibility and responsiveness of health status measures statistics and strategies for evaluation. Control Clin Trials 1991 Aug PMID: 1663851. DOI: https://doi.org/10.1016/S0197-2456(05)80019-4
Ridge ST, Myrer JW, Olsen MT, Jurgensmeier K, Johnson AW. Reliability of doming and toe flexion testing to quantify foot muscle strength. J Foot Ankle Res. 2017 Dec 8. PMID: 29234467; PMCID: PMC5723035 DOI: https://doi.org/10.1186/s13047-017-0237-y
Nguyen QD, Moodie EM, Desmarais P, Goulden R, Forget MF, Peters E, Saeed S, Keezer MR, Wolfson C. Appraising clinical applicability of studies: mapping and synthesis of current frameworks, and proposal of the FrACAS framework and VICORT checklist. BMC Med Res Methodol. 2021 Nov 14. PMID: 34773994; PMCID: PMC8590785. DOI: https://doi.org/10.1186/s12874-021-01445-0
Linan Z, Qiusha Y, Chuan Z, Chao H, Hailong L, Chunsong Y, Mao L, Liang H, Dan L, Deying K, Guanjian L, Qiaolan L, Rongsheng Z, Junhua Z, Youping L, Hanmin L, Qiang W, Lingli Z. An instrument for evaluating the clinical applicability of guidelines. J Evid Based Med. 2020 Sept. Epub ahead of print. PMID: 33090726; PMCID: PMC7984040. DOI: https://doi.org/10.1111/jebm.12416
Revicki DA, Cella D, Hays RD, Sloan JA, Lenderking WR, Aaronson NK. Responsiveness and minimal important differences for patient reported outcomes. Health Qual Life Outcomes. 2006 Sept 27. PMID: 17005038; PMCID: PMC1586195. DOI: https://doi.org/10.1186/1477-7525-4-70
Ishigaki EY, Ramos LG, Carvalho ES, Lunardi AC. Effectiveness of muscle strengthening and description of protocols for preventing falls in the elderly: a systematic review. Braz J Phys Ther. 2014 Apr 22 Epub 2014 Apr 22. PMID: 24760166; PMCID: PMC4183251
Chatzistergos PE, Healy A, Naemi R, Sundar L, Ramachandran A, Chockalingam N. The relationship between hallux grip force and balance in people with diabetes. Gait Posture. 2019 Epub 2019 Feb 23. PMID: 30849605. DOI: https://doi.org/10.1016/j.gaitpost.2019.02.020
Tsekoura M, Billis E, Kastrinis A, Katsoulaki M, Fousekis K, Tsepis E, Konstantoudaki X, Gliatis J. The Effects of Exercise in Patients with Sarcopenia. Adv Exp Med Biol. 2021. PMID: 34972915.. DOI: https://doi.org/10.1007/978-3-030-78771-4_31
Stasi S, Tsekoura M, Gliatis J, Sakellari V. The Effects of a Home-Based Combined Motor Control and Ergonomic Program on Functional Ability and Fear of Falling: A Randomized Controlled Trial. Cureus. 2021 Sept. PMID: 34725593; PMCID: PMC8553279. DOI: https://doi.org/10.7759/cureus.18330
Gillespie LD, Robertson MC, Gillespie WJ, Lamb SE, Gates S, Cumming RG, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. Apr 15 Update in: Cochrane Database Syst Rev. 2012;9:CD007146. PMID: 19370674. DOI: https://doi.org/10.1002/14651858.CD007146.pub3
Hile ES, Ghazi M, Chandrashekhar R, Rippetoe J, Fox A, Wang H. Development and Earliest Validation of a Portable Device for Quantification of Hallux Extension Strength (QuHalEx). Sensors (Basel). 2023 May 11. PMID: 37430569; PMCID: PMC10223981. DOI: https://doi.org/10.3390/s23104654
Sherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, Howard K, Clemson L, Hopewel Sl, Lamb SE. Exercise for preventing falls in older people living in the community, Cochrane Database Syst. Rev. 2019 Jan 31 PMID: 30703272; PMCID: PMC6360922. DOI: https://doi.org/10.1002/14651858.CD012424.pub2
Rowan Hillson. The big toe in diabetes. Practical diabetes. 2020 Nov 30 doi.org/10.1002/pdi.2305 DOI: https://doi.org/10.1002/pdi.2305
Yu S, Appleton S, Chapman I, Adams R, Wittert G, Visvanathan T, Visvanathan R. An anthropometric prediction equation for appendicular skeletal muscle mass in combination with a measure of muscle function to screen for sarcopenia in primary and aged care. J Am Med Dir Assoc. 2015 Jan. Epub 2014 Sep 18. PMID: 25239016. DOI: https://doi.org/10.1016/j.jamda.2014.06.018

How to Cite

Tsekoura, M., Pantou, M., Fousekis, K., Billis, E., Gliatis, J., & Tsepis, E. (2023). Reliability and clinical applicability of lower limp strength using an enhanced paper grip strength. European Journal of Translational Myology, 33(4). https://doi.org/10.4081/ejtm.2023.11841