Clinical effectiveness of grip strength in predicting ambulation of elderly inpatients.
BACKGROUND
Assessing the clinical effectiveness of measuring grip strength as a prognostic tool in recovering ambulation in bed-confined frail elderly patients.


METHODS
A prospective study was carried out with 50 elderly inpatients (mean age: 81.6 years old). Manual muscle test was used for checking strength of hip flexor muscles, hip abductor muscles and knee extensor muscles. Grip strength was assessed by hydraulic dynamometer. Walking ability was assessed by functional ambulation categories and Functional Classification of Sagunto Hospital Ambulation. Existence of cognitive impairment (Short Portable Mental Status of Pfeiffer) and comorbidity (abbreviated Charlson index) were considered to be confounding variables.


METHODS
Simple comparisons and mixed models of multiple ordinal regression.


RESULTS
The sample presented generalized weakness in scapular (mean 4.22) and pelvic (mean 3.82) muscle. Mean hand grip values were similar: 11.98 kg right hand; 11.70 kg left hand. The patients had lost walking ability. After treatment, there was a statistically significant for scapular waist strength (P=0.001), pelvic waist strength (P=0.005) and walking ability (P=0.001). A statistically significant relationship in the regression analysis was found between the grip (right and left hands) and walking ability post-treatment (P=0.009; odds ratio 1.14 and P=0.0014 odds ratio 1.113 for each walking scale). The confounding variables showed no statistical significance in the results.


CONCLUSIONS
Grip strength is associated with walking ability in hospitalized frail elderly. Grip strength assessment by hydraulic dynamometry is useful in patients with poor collaboration. Walking ability training in frail elderly inpatients is useful.
Physical Medicine and Rehabilitation, La Fe Hospital, Valencia, Spain.
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Beseler
Physical Medicine and Rehabilitation, La Fe Hospital, Valencia, Spain.
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C
Rubio
Physical Medicine and Rehabilitation, La Fe Hospital, Valencia, Spain.
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Duarte
Statistical Unit, La Fe Hospital, Valencia, Spain.
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D
Hervás
Physical Medicine and Rehabilitation, La Fe Hospital, Valencia, Spain.
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MC
Guevara
Physical Medicine and Rehabilitation, La Fe Hospital, Valencia, Spain.
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Giner-Pascual
Physical Medicine and Rehabilitation, La Fe Hospital, Valencia, Spain.
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Viosca
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006760:Hospitalization; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D018482:Muscle, Skeletal / Q000502:physiology; D011379:Prognosis; D011446:Prospective Studies; D016138:Walking / Q000502:physiology*
elderly; gait; hand grip; physical therapy