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A Novel Device for the Measurement of Intrinsic Strength
Ashley Kim, BScH, MD; Shrikant Chinchalkar, MThO, OTR, CHT; Louis Ferreira, PhD, P Eng; Christopher Doherty, MD, FRCSC
Western University, London, ON, Canada
Introduction: In the clinical evaluation and research of patients with ulnar nerve neuropathy, muscle strength measurements are currently based on manual muscle strength testing (MMST) or grip strength and pinch strength dynamometry. MMST is variable between clinicians and lacks sensitivity. An intrinsic dynamometer was developed to measure abduction/adduction forces of all fingers requiring minimal involvement from the clinician. This study aims to examine the reliability and validity of the device.
Methods: The intrinsic dynamometer is a stationary device consisting of a force sensor (load cell) that connects to an amplifier, calibrated by applying known forces against the active prong of the apparatus. Volunteers were recruited from students and staff at Western University and St. Joseph's Hospital. Conventional measurements of intrinsic strength were recorded (grip strength, key pinch and tripod) as well as repeated measurements of abduction and adduction in all digits.
Results: Twenty healthy participants were recruited (ten males and ten females, age range 20 – 65 years). Test-retest reliability was found to be high for the device (Pearson coefficient 0.80 – 0.91, p<0.05). A weak but positive correlation was found between conventional methods of measuring grip strength to intrinsic strength measurements. Normative data show increasing strength of abduction/adduction towards the radial digits. No difference was found in intrinsic strength of dominant vs non-dominant hands.
Discussion: MMST and conventional hand dynamometry does not reliably measure intrinsic muscle strength. The accuracy, reliability and validity for such a device have implications for the evaluation of treatment outcomes and ulnar nerve recovery. Intrinsic strength in healthy subjects has not yet been measured in previous literature. By establishing normative data, there exists a comparison for documenting, following, and providing feedback for clinicians treating patients with ulnar neuropathies or disorders affecting intrinsic strength.
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