Reliability of maximal grip strength measurements and grip strength recovery following a stroke.

STUDY DESIGN: Clinical measurement. PURPOSE: The test-retest reliability of maximal grip strength measurements (MGSM) is examined in subjects for 12 weeks post-stroke together with maximal grip strength recovery and the maximal-grip and upper-extremity strength measurements' relationship with capacity and performance test scores. METHODS: A Jamar dynamometer and the Motricity Index (MI) were used for strength measurements. The Chedoke Arm and Hand Activity Inventory and ABILHAND questionnaire for evaluating capacities and performances. RESULTS: MGSM were reliable (Intraclass Correlation Coefficients = 0.97-0.99, Minimal Detectable Differences = 2.73-4.68 kg). Among the 34 participants, 47% did not have a measurable grip strength one week post-stroke but 50% of these recovered some strength within the first eight weeks. The MGSM and MI scores were correlated with scores of tests of capacity and performance (Spearman's Rank Correlation Coefficients = 0.69-0.94). CONCLUSIONS: MGSM are reliable in the first weeks after a stroke. LEVEL OF EVIDENCE: N/A.

A diabetic patient presenting with stiff hand following fasciectomy for Dupuytren's contracture: A case report.

Reported is the case of a 68-year-old male presenting with severe wrist and hand stiffness following surgery for a Dupuytren's contracture. Complications of surgery or rehabilitation and complex regional pain syndrome were excluded as factors explaining this stiffness. Given the patient's diabetes mellitus and the striking similarity with the typical diabetic stiff hand, it is suggested that diabetes may have contributed to the development of the complication.

Reliability and validity of pinch and thumb strength measurements in de Quervain's disease.

The purpose of this study is to evaluate the test-retest reliability and construct validity of pinch and thumb strength measurements in subjects with de Quervain's disease. Maximal palmar pinch and thumb strength (adduction, extension, abduction, and flexion) were measured using, respectively, a pinch gauge and a biaxial dynamometer. The reliability was estimated using the generalizability theory. The validity hypotheses were as follows: 1) the pinch and thumb strength of the symptomatic side would be significantly lower than that of the asymptomatic side, and 2) the strength loss would be greater for thumb extension and abduction. The reliability was high for all strength measurements, pinch strength being the more reliable one. The pinch and thumb strength in all directions evaluated was significantly decreased on the symptomatic side (p<0.003); no direction showed a greater decrease than the others. The results suggest that pinch and thumb strength measurements are reliable and able to show a decreased strength on the symptomatic side in this population.