Understanding hand grip measures in geriatric inpatients: associations with frailty, daily functioning and fatigue

Background

Hand grip measures are promising candidate markers for recovery in geriatric patients.

Aims

To advance interpretation of these measures, we examined: (1) the associations between grip measures at admission and measures of frailty, daily functioning and fatigue to understand the constructs they measure; (2) alternate operational definitions of grip measures.

Methods

181 geriatric inpatients completed twice daily grip measurements using the Eforto^® vigorimeter, including maximum grip strength (GSmax), fatigue resistance (FR), grip work (GW) and capacity to perceived vitality ratio (CPV). Associations with each of these measures and the outcomes frailty index (range 0-100), functional limitations (10–40), and total (4–20) and physical (20–100) fatigue were examined using linear regression. Analyses were repeated for the baseline value, average of first two measurements, within-person standard deviation of all values, and the coefficient of variation of all values for each of the grip measures.

Results

Associations approached statistical significance for baseline GSmax and the outcomes frailty (B=-0.09, 99%CI=--0.21, 0.02), functional limitations (B=-0.10, 99%CI=-0.20, 0) and physical fatigue (B=-0.07, 99%CI=-0.14, 0). Baseline, average and standard deviation values for FR, GW and CPV showed trends towards associations with functional limitations, but not with frailty or fatigue.

Conclusions

GSmax and CPV constructs overlapped more strongly with the construct of frailty than FR and GW. FR, GW and CPV overlapped with functional limitations, supporting their potential as early markers of recovery. Average values are more reliable than single values and variance measures may add additional information.