title: Comparison Between Handgrip Dynamometry and Manual Muscle Testing Performed by Registered Dietitians in Measuring Muscle Strength and Function of Hospitalized Patients.
abstract: The Academy of Nutrition and Dietetics and American Society the Parenteral and Enteral Nutrition (ASPEN) Consensus Statement recommends a standardized set of diagnostic characteristics to identify adult malnutrition. Due to lack of a consensus definition and challenges with measurements, physical function or performance has traditionally been difficult to assess. The purpose of this study was to determine whether manual muscle testing (MMT) performed by registered dietitians (RDs) can be used as a surrogate measurement of muscle strength and function in hospitalized patients.
  
  
  
  Patients admitted to the heart failure service on the cardiac stepdown units at the Cleveland Clinic Main Campus in Cleveland, Ohio, were eligible for the study, and those who met the inclusion criteria underwent handgrip strength (HGS) testing and evaluation of nutrition status using the Academy/ASPEN Characteristics Recommended for the Identification of Adult Malnutrition. MMT was then performed within 24 hours by a different study investigator blinded to the HGS and malnutrition assessment results.
  
  
  
  It was found that HGS and MMT overall were in agreement for 84% of patients and that MMT had a high sensitivity (98%) but low specificity (13%).
  
  
  
  This study shows feasibility for RDs to perform MMT on patients to determine muscle strength and functioning. Future practice application may be to incorporate MMT into screening criteria for patients being evaluated for malnutrition and reserve HGS testing only for patients with an abnormal MMT.
authors: Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA dowhanl@ccf.org.
authors: Lindsay
authors: L
authors: Dowhan
authors: Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Robert
authors: R
authors: DeChicco
authors: Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Renee
authors: R
authors: Welsh
authors: Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Rebecca
authors: R
authors: Wehner
authors: Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Monica
authors: M
authors: Habib
authors: Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Peggy
authors: P
authors: Hipskind
authors: Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors: Gail
authors: G
authors: Cresci
mesh_terms: D000368:Aged; D005240:Feasibility Studies; D005260:Female; D018737:Hand Strength; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000175:diagnosis; D008875:Middle Aged; D053580:Muscle Strength; D053581:Muscle Strength Dynamometer; D015596:Nutrition Assessment; D009752:Nutritional Status; D064686:Nutritionists; D009820:Ohio; D011446:Prospective Studies; D012680:Sensitivity and Specificity
keywords: adult; functional assessment; life cycle; malnutrition; nutrition; nutrition assessment