Changes in Function and Muscle Strength of Encephalitis Survivors After Inpatient Rehabilitation

Objective To investigate the clinical demographics and rehabilitative assessments of encephalitis survivors admitted to a rehabilitation center, and to confirm the effects of inpatient rehabilitation manifested by changes in muscle strength and function after hospitalization.Methods Data of encephalitis survivors who received rehabilitation at our institution from August 2009 to August 2019 were reviewed. Medical charts were retrospectively reviewed, and motor, functional, and cognitive assessments were collected. Manual muscle testing (MMT), Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS), Functional Ambulation Category (FAC), Korean version of Modified Barthel Index (K-MBI), grip strength, Box and Block Test (BBT), and Korean version of Mini-Mental State Examination (K-MMSE) were performed, and the results upon admission and discharge were compared and analyzed.Results Most of the patients with encephalitis admitted to our institution had viral or autoimmune etiologies. The assessment results of 18 encephalitis patients upon admission and discharge were compared. The total K-MBI score, FAC, grip strength, and BBT significantly improved, but not the MMT and FMA. Subgroup analysis was performed for viral and autoimmune encephalitis, which are the main causes of the disease, but there was no difference in items with significant changes before and after hospitalization.Conclusion Encephalitis survivors showed a significant improvement in functional assessment scale during their hospital stay through rehabilitation, without significant changes in motor strength. Hence, we can conclude that encephalitis survivors benefit from inpatient rehabilitation, targeting functional gains in activities of daily living training more than motor strength.

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Manual Muscle Testing: A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients

Journal of Visualized Experiments ◽

10.3791/2632 ◽

2011 ◽

Cited By ~ 7

Author(s):

Nancy Ciesla ◽

Victor Dinglas ◽

Eddy Fan ◽

Michelle Kho ◽

Jill Kuramoto ◽

...

Keyword(s):

Muscle Strength ◽

Critically Ill ◽

Critically Ill Patients ◽

Manual Muscle Testing ◽

Muscle Testing

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Global Muscle Strength But Not Grip Strength Predicts Mortality and Length of Stay in a General Population in a Surgical Intensive Care Unit

Physical Therapy ◽

10.2522/ptj.20110403 ◽

2012 ◽

Vol 92 (12) ◽

pp. 1546-1555 ◽

Cited By ~ 36

Author(s):

Jeanette J. Lee ◽

Karen Waak ◽

Martina Grosse-Sundrup ◽

Feifei Xue ◽

Jarone Lee ◽

...

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Length Of Stay ◽

Hospital Mortality ◽

Grip Strength ◽

Muscle Weakness ◽

Manual Muscle Testing ◽

Surgical Intensive Care Unit ◽

Muscle Testing

Background Paresis acquired in the intensive care unit (ICU) is common in patients who are critically ill and independently predicts mortality and morbidity. Manual muscle testing (MMT) and handgrip dynamometry assessments have been used to evaluate muscle weakness in patients in a medical ICU, but similar data for patients in a surgical ICU (SICU) are limited. Objective The purpose of this study was to evaluate the predictive value of strength measured by MMT and handgrip dynamometry at ICU admission for in-hospital mortality, SICU length of stay (LOS), hospital LOS, and duration of mechanical ventilation. Design This investigation was a prospective, observational study. Methods One hundred ten patients were screened for eligibility for testing in the SICU of a large, academic medical center. The Acute Physiology and Chronic Health Evaluation (APACHE) II score, diagnoses, and laboratory data were collected. Measurements were obtained by MMT quantified with the sum (total) score on the Medical Research Council Scale and by handgrip dynamometry. Outcome data, including in-hospital mortality, SICU LOS, hospital LOS, and duration of mechanical ventilation, were collected for all participants. Results One hundred seven participants were eligible for testing; 89% were tested successfully at a median of 3 days (25th–75th percentiles=3–6 days) after admission. Sedation was the most frequent barrier to testing (70.6%). Manual muscle testing was identified as an independent predictor of mortality, SICU LOS, hospital LOS, and duration of mechanical ventilation. Grip strength was not independently associated with these outcomes. Limitations This study did not address whether muscle weakness translates to functional outcome impairment. Conclusions In contrast to handgrip strength, MMT reliably predicted in-hospital mortality, duration of mechanical ventilation, SICU LOS, and hospital LOS.

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Effect of Isometric and Isotonic Exercise Program on Increased Strength of Quardriceps Muscles in Osteoarthritis Patients in Singgasana Rama Physiotherapy Clinic Blitar

JOURNAL FOR QUALITY IN PUBLIC HEALTH ◽

10.30994/jqph.v5i1.246 ◽

2021 ◽

Vol 5 (1) ◽

pp. 42-48

Author(s):

Irwan Syahputra ◽

Nurwijayanti Nurwijayanti

Keyword(s):

Muscle Strength ◽

Exercise Program ◽

Quadriceps Strength ◽

Manual Muscle Testing ◽

Moderate Intensity ◽

Rank Test ◽

Control Group ◽

Isometric Training ◽

Muscle Testing ◽

Isotonic Exercise

Background: Osteoarthritis is a disease of the joints that can cause disability and is progressive in the joints which cause changes in the water content, proteoglycin content, and collagen in the joints. One of the ways to improve functional ability in osteoarthritis cases is to use isotonic and isometric training exercise. Pain is a clinical symptom of knee osteoarthritis, limiting movement due to pain over time will cause rehabilitation problems such as impaired flexibility and stability, reduction of muscle mass (atrophy). Mild and moderate intensity quadriceps strength training is effective at achieving optimal muscle strength and function without causing significant muscle damage. Destination: The purpose of this study was to analyze the effect of isotonic and isometric exercises on muscle strength. Research methods: This study uses a pre-experimental research type using "One Group Pre - test and Post - Test". This research has carried out the first observation (pretest) so that researchers can test the changes that occur after the treatment, and the control group. Result: with the Wilcoxon signed rank test test the isometric and isotonic groups had p = 0.000 while the control group had a significance value of p = 1,000; and the 3 groups test has different values, namely: isotonic exercise has a value of 27.67; isometric; 28.60; and control 12.73. The conclusion that can be concluded that the value of isometric training has the highest value, namely 28.60 which means it is the most effective exercise to increase the value of Manual Muscle Testing. Conclusion: There is an effect of giving isometric and isotonic exercises in strengthening the quadriceps muscles.

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Toward Consensus in Assessing Upper Limb Muscle Strength and Pinch and Grip Strength in People With Tetraplegia Having Upper Limb Reconstructions

Topics in Spinal Cord Injury Rehabilitation ◽

10.46292/sci20-00012 ◽

2021 ◽

Author(s):

Jennifer A. Dunn ◽

Sabrina Koch-Borner ◽

M. Elise Johanson ◽

Johanna Wangdell

Keyword(s):

Grip Strength ◽

Upper Limb ◽

Manual Muscle Testing ◽

Pinch Strength ◽

Consensus Methods ◽

Serratus Anterior ◽

Multicenter Studies ◽

International Consensus ◽

Muscle Testing ◽

Upper Limb Surgery

Objectives: To reach agreement on standardized protocols for assessing upper limb strength and grip and pinch force for upper limb reconstructive surgery for tetraplegia. Methods: Selected members of an expert panel composed of international therapists formed at the 2018 International Congress for Upper Limb Surgery for Tetraplegia conducted a literature review of current practice that identified gaps and inconsistencies in measurement protocols and presented to workshop attendees. To resolve discrepancies, a set of questions was presented to workshop attendees who voted electronically. Consensus was set at 75% agreement. Results: For manual muscle testing, consensus was reached for using the Medical Research Council scale, without plus or minus, and the use of resistance through range when testing grade 4 and grade 5 strength. Pectoralis major and serratus anterior should be routinely tested, however there was no consensus on other shoulder muscles. Grip and pinch strength should be tested according to the American Society of Hand Therapists positioning. For grip strength, either the Jamar or Biometrics dynamometer expressed in kilograms should be used. For grip and pinch strength, three measurements should be performed at each testing. No consensus was reached on a device for pinch strength. Conclusion: This work is an important step to enable comparable data in the future. Further consensus methods will work toward developing more comprehensive guidelines in this population. Building international consensus for pre- and postoperative measures of function supports objective evaluation of novel therapies and interpretation of multicenter studies.

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Hand-held dynamometry for assessment of muscle strength in patients with inflammatory myopathies

Rheumatology ◽

10.1093/rheumatology/keaa419 ◽

2020 ◽

Author(s):

Didem Saygin ◽

Chester V Oddis ◽

Siamak Moghadam-Kia ◽

Bonny Rockette-Wagner ◽

Nicole Neiman ◽

...

Keyword(s):

Muscle Strength ◽

Disease Activity ◽

Neuromuscular Disorders ◽

Strong Association ◽

External Validation ◽

Manual Muscle Testing ◽

Inflammatory Myopathies ◽

University Of Pittsburgh ◽

Muscle Testing ◽

The University

Abstract Objectives Muscle weakness in idiopathic inflammatory myopathies (IIMs) is conventionally assessed using manual muscle testing (MMT). However, more objective tools must be developed to accurately and reliably quantify muscle strength in myositis patients. Hand-held dynamometry (HHD) is a quantitative, portable device with reported reliability in neuromuscular disorders. Our aim was to assess the reliability, validity and responsiveness of HHD in myositis. Methods Myositis patients [DM, necrotizing myopathy (NM), PM and anti-synthetase syndrome] evaluated at the University of Pittsburgh myositis centre were prospectively enrolled. Each patient was assessed at 0, 3 and 6 months for validated outcome measures of myositis disease activity and physical function. At each visit, muscle strength was assessed using both MMT and HHD (Micro FET2, Hoggan Health Industries, Draper, UT, USA). The reliability, validity and responsiveness of the HHD was assessed using standard statistical methods. Results Fifty IIM patients (60% female; mean age 51.6 years; 6 PM, 9 NM, 24 DM and 11 anti-synthetase syndrome) were enrolled. HHD showed strong test–retest intrarater reliability (r = 0.96) and interrater reliability (r = 0.98). HHD correlated significantly with the MMT score (r = 0.48, P = 0.0006) and myositis disease activity and functional measures. Longitudinal analysis showed a significant and strong association between the HHD and MMT as well as 2016 ACR/EULAR myositis response criteria (r = 0.8, P < 0.0001) demonstrating responsiveness. The mean effect size and standardized response mean of HHD was large: 0.95 and 1.03, respectively. MMT had a high ceiling effect compared with HHD. Conclusion HHD demonstrated strong reliability, construct validity and responsiveness in myositis patients. External validation studies are required to confirm these findings.

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Large variation in effects during 10 years of enzyme therapy in adults with Pompe disease

Neurology ◽

10.1212/wnl.0000000000008441 ◽

2019 ◽

Vol 93 (19) ◽

pp. e1756-e1767 ◽

Cited By ~ 12

Author(s):

Laurike Harlaar ◽

Jean-Yves Hogrel ◽

Barbara Perniconi ◽

Michelle E. Kruijshaar ◽

Dimitris Rizopoulos ◽

...

Keyword(s):

Muscle Strength ◽

Pulmonary Function ◽

Pompe Disease ◽

Manual Muscle Testing ◽

Controlled Clinical Trial ◽

Walking Ability ◽

Enzyme Replacement ◽

Link Type ◽

Muscle Testing

ObjectiveTo determine the effects of 10 years of enzyme replacement therapy (ERT) in adult patients with Pompe disease, focusing on individual variability in treatment response.MethodsIn this prospective, multicenter cohort study, we studied 30 patients from the Netherlands and France who had started ERT during the only randomized placebo-controlled clinical trial with ERT in late-onset Pompe disease (NCT00158600) or its extension (NCT00455195) in 2005 to 2008. Main outcomes were walking ability (6-minute walk test [6MWT]), muscle strength (manual muscle testing using Medical Research Council [MRC] grading), and pulmonary function (forced vital capacity [FVC] in the upright and supine positions), assessed at 3- to 6-month intervals before and after the start of ERT. Data were analyzed with linear mixed-effects models for repeated measurements.ResultsMedian follow-up duration on ERT was 9.8 years (interquartile range [IQR] 8.3–10.2 years). At the group level, baseline 6MWT was 49% of predicted (IQR 41%–60%) and had deteriorated by 22.2 percentage points (pp) at the 10-year treatment point (p < 0.001). Baseline FVC upright was 54% of predicted (IQR 47%–68%) and decreased by 11 pp over 10 years (p < 0.001). Effects of ERT on MRC sum score and FVC supine were similar. At the individual level, 93% of patients had initial benefit of ERT. Depending on the outcome measured, 35% to 63% of patients had a secondary decline after ≈3 to 5 years. Still, at 10 years of ERT, 52% had equal or better 6MWT and/or FVC upright compared to baseline.ConclusionsThe majority of patients with Pompe disease benefit from long-term ERT, but many patients experience some secondary decline after ≈3 to 5 years. Individual variation, however, is considerable.Classification of evidenceThis study provides Class IV evidence that for the majority of adults with Pompe disease, long-term ERT positively affects, or slows deterioration in, muscle strength, walking ability, and/or pulmonary function.

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Assessing the Validity and Reliability of A Low-Cost Microcontroller-Based Load Cell Amplifier for Measuring Lower Limb and Upper Limb Muscular Force

Sensors ◽

10.3390/s20174999 ◽

2020 ◽

Vol 20 (17) ◽

pp. 4999

Author(s):

Julie Gaudet ◽

Grant Handrigan

Keyword(s):

Muscle Strength ◽

Upper Limb ◽

Low Cost ◽

Load Cell ◽

Manual Muscle Testing ◽

Muscular Force ◽

Validity And Reliability ◽

Important Indicator ◽

Muscle Testing ◽

Isometric Muscle

Lower and upper limb maximum muscular force development is an important indicator of physical capacity. Manual muscle testing, load cell coupled with a signal conditioner, and handheld dynamometry are three widely used techniques for measuring isometric muscle strength. Recently, there is a proliferation of low-cost tools that have potential to be used to measure muscle strength. This study examined both the criterion validity, inter-day reliability and intra-day reliability of a microcontroller-based load cell amplifier for quantifying muscle strength. To do so, a low-cost microcontroller-based load cell amplifier for measuring lower and upper limb maximal voluntary isometric muscular force was compared to a commercial grade signal conditioner and to a handheld dynamometer. The results showed that the microcontroller-based load cell amplifier correlated nearly perfectly (Pearson's R-values between 0.947 to 0.992) with the commercial signal conditioner and the handheld dynamometer, and showed good to excellent association when calculating ICC scores, with values of 0.9582 [95% C.I.: 0.9297–0.9752] for inter-day reliability and of 0.9269 [95% C.I.: 0.8909–0.9533] for session one, intra-day reliability. Such results may have implications for how the evaluation of muscle strength measurement is conducted in the future, particularly for offering a commercial-like grade quality, low cost, portable and flexible option.

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