Does grip strength predict lower limb global strength in subjects with stroke?

Grip strength is an important clinical measure and has been used for several purposes in different populations, including those to predict the global strength of lower limbs (LL) and upper limbs. However, little is known about the association between grip strength and lower limb (LL) global strength in subjects with stroke.

Objective:

To investigate the relationship between grip strength and LL global strength in stroke with subjects at both subacute and chronic phases.

Method:

Measures of grip strength (handgrip dynamometer) and LL global strength (hand-held dynamometer) were obtained in 20 subjects in the subacute phase of the stroke and 18 in the chronic phase. Pearson correlation coefficient was used to investigate the correlation between grip strength and LL global strength (α = 0.05).

Results:

Subjects in the subacute phase showed a moderate statistically significant correlation between paretic grip strength and global strength of the non-paretic LL (r = 0.50; p < 0.05), but no correlation with the paretic LL was found (p = 0.25). The non-paretic grip strength showed no statistically significant correlation with global strength of the paretic LL (p = 0.93) and of the non-paretic LL (p = 0.64). In chronic subjects, no statistically significant correlation (0.50 ≤ p ≤ 0.97) was observed.

Conclusion:

Grip strength does not seem to be an adequate indicator to predict LL global strength of subjects with stroke. This conclusion is different from that obtained for other populations.

Keywords
Stroke; Hand Strength; Muscle Strength; Lower Extremity; Disability Evaluation

Muscle group	Participant’s position	Position of the segment	Position of the device	Stabilization
Hip flexors	Supine	Hip and knee flexed to 90º and ankle in neutral position	Distal and anterior aspect of the thigh	None
Hip extensors	Supine	Hip and knee to 90º and ankle in neutral position	Distal and posterior aspect of the thigh	None
Hip abductors	Supine	Hip in neutral and knee extended	Distal and lateral aspect of the thigh	None
Plantar flexors	Supine	Hip and knee to 90º and ankle in neutral position	Proximal to metatarsophalangeal joints on the plantar surfaces	Distal and anterior aspect of the leg
Ankle dorsiflexors	Supine	Hip and knee extended and ankle in neutral position	Proximal to metatarsophalangeal joints on the dorsal surfaces	Distal and anterior aspect of the leg
Knee flexors	Seated	Hip and knee flexed to 90º	Distal and posterior aspect of the leg	Distal and posterior aspect of the leg
Knee extensors	Seated	Hip and knee flexed to 90º	Distal and anterior aspect of the leg	Distal and anterior aspect of the leg
Handgrip	Seated	Shoulder adducted, elbow flexed to 90°, forearm in neutral position, wrist with 0 to 30º extension	Palm of the hand	Distal aspect of the forearm

Characteristics	Subacute (n = 20)	Chronic (n = 18)
Age (years): mean ± SD [min-max]	64.05 ± 11.94 [36-85]	58.50 ± 15.43[30-86]
Time since the onset of stroke (months): mean ± SD [min-max]	3.0 ± 0.69 [3-5]	102.89 ± 89.95 [7-370]
Body mass index (kg/m²), mean ± SD [min-max]	25.49 ± 4.21 [18.71-36.66]	26.29 ± 3.48 [21.74-33.84]
Sex: Men, n (%)	10 (50)	18 (75)
Paretic side: right, n (%)	14 (53.8)	9 (25)
Type of stroke: n (%)
Ischemic	19 (73.1)	13 (72.25)
Hemorrhagic	1 (3.8)	2 (11.1)
Both, Ischemic and Hemorrhagic	-	1 (5.55)
Not reported	-	2 (11.1)
Fulg-Meyer: (0-100), n (%)
Mild motor impairment	7 (35)	3 (16.6)
Moderately motor impairment	11 (55)	5 (27.7)
Moderately Severe motor impairment	2 (10)	9 (50.15)
Very Severe motor impairment	-	1 (5.55)
Physical activity level: n (%)
Vigorous active	-	1 (5.6)
Moderate active	-	-
Insufficient	-	4 (22.1)
Inactive	20 (100)	13 (72.3)

Variables	Global strength of paretic lower-limb	Global strength of non-paretic lower-limb
Subacute phase
rip strength of non-paretic side	p = 0.93	p = 0.64
Grip strength of paretic side	p = 0.25	r = 0.50; p < 0.05
Chronic phase
Grip strength of non-paretic side	p = 0.97	p = 0.50
Grip strength of paretic side	p = 0.85	p = 0.62

Pontifícia Universidade Católica do Paraná Rua Imaculada Conceição, 1155 - Prado-Velho -, Curitiba - PR - CEP 80215-901, Telefone: (41) 3271-1608 - Curitiba - PR - Brazil
E-mail: revista.fisioterapia@pucpr.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] *JF: MS, e-mail: julianef_@hotmail.com LFQ: MS, e-mail: ferreiraquintino@hotmail.com CDCMF: PhD, e-mail: cdcmf@ufmg.br