Comparison of hand grip strength and upper limb pressure pain threshold between older adults with or without non-specific shoulder pain

Cesar Calvo Lobo, Carlos Romero Morales, David Rodríguez Sanz, Irene Sanz Corbalán, Eleuterio A Sánchez Romero, Josué Fernández Carnero, Daniel López López, Cesar Calvo Lobo, Carlos Romero Morales, David Rodríguez Sanz, Irene Sanz Corbalán, Eleuterio A Sánchez Romero, Josué Fernández Carnero, Daniel López López

Abstract

Background: There is a high prevalence of non-specific shoulder pain associated with upper limb functional limitations in older adults. The purpose of this study was to determine the minimal clinically important differences (MCID) of grip strength and pressure pain threshold (PPT) in the upper limb between older adults with or without non-specific shoulder pain.

Methods: A case-control study was carried out following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria. A sample of 132 shoulders (mean ± SD years) with (n = 66; 76.04 ± 7.58) and without (n = 66; 75.05 ± 6.26) non-specific pain were recruited. The grip strength and PPT of the anterior deltoid and extensor carpi radialis brevis (ECRB) muscles were assessed.

Results: There were statistically significant differences (mean ± SD; P-value) for anterior deltoid PPT (2.51 ± 0.69 vs 3.68 ± 0.65, kg/cm2; P < .001), ECRB PPT (2.20 ± 0.60 vs 3.35 ± 0.38 kg/cm2; P < .001) and grip strength (20.78 ± 10.94 vs 24.63 ± 9.38 kg; P = .032) between shoulders with and without non-specific pain, respectively.

Discussion: The MCID of 1.17 kg/cm2, 1.15 kg/cm2 and 3.84 kg were proposed for anterior deltoid PPT, ECRB PPT and grip strength, respectively, to assess the upper limb of older adults with non-specific shoulder pain after treatment. In addition, univariate and multivariate (linear regression and regression trees) analyses may be used to consider age distribution, sex, pain intensity, grip strength and PPT in older adults including clinical and epidemiological studies with non-specific shoulder pain.

Keywords: Aged; Hand strength; Myofascial pain syndromes; Referred pain; Shoulder pain; Trigger points.

Conflict of interest statement

The authors declare there are no competing interests.

Figures

Figure 1. Box plots to illustrate anterior…
Figure 1. Box plots to illustrate anterior deltoid PPT values between shoulders with and without pain.
Abbreviations: MCID, minimal clinically important differences; PPT, pressure pain threshold.
Figure 2. Box plots to illustrate ECRB…
Figure 2. Box plots to illustrate ECRB PPT values between shoulders with and without pain.
Abbreviations: ECRB, extensor carpi radialis brevis; MCID, minimal clinically important differences; PPT, pressure pain threshold.
Figure 3. Box plots to illustrate grip…
Figure 3. Box plots to illustrate grip strength values between shoulders with and without pain.
Abbreviations: MCID, minimal clinically important differences.
Figure 4. Regression tree nodes to predict…
Figure 4. Regression tree nodes to predict the grip strength, anterior deltoid and ECRB PPT.
Abbreviations: ECRB, extensor carpi radialis brevis; PPT, pressure pain threshold.
Figure 5. Bland and Altman 2 graphs,…
Figure 5. Bland and Altman2 graphs, completed with linear regression analysis, of the intra-examiner reliability of the anterior deltoid (A) and ECRB (B) latent MTrPs localization procedure.
Abbreviations: ECRB, extensor carpi radialis brevis; MTrPs, myofascial trigger points.

References

    1. Abizanda P, Navarro JL, García-Tomás MI, López-Jiménez E, Martínez-Sánchez E, Paterna G. Validity and usefulness of hand-held dynamometry for measuring muscle strength in community-dwelling older persons. Archives of Gerontology and Geriatrics. 2012;54(1):21–27. doi: 10.1016/j.archger.2011.02.006.
    1. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. International Journal of Nursing Studies. 2010;47(8):931–936. doi: 10.1016/j.ijnurstu.2009.10.001.
    1. Bohannon RW. Hand-grip dynamometry predicts future outcomes in aging adults. Journal of Geriatric Physical Therapy. 2008;31:3–10. doi: 10.1519/00139143-200831010-00002.
    1. Bohannon RW, Magasi S. Identification of dynapenia in older adults through the use of grip strength t-scores. Muscle and Nerve. 2015;51(1):102–105. doi: 10.1002/mus.24264.
    1. Burner T, Abbott D, Huber K, Stout M, Fleming R, Wessel B, Massey E, Rosenthal A, Burns E. Shoulder symptoms and function in geriatric patients. Journal of Geriatric Physical Therapy. 2014;37:154–158. doi: 10.1519/JPT.0b013e3182abe7d6.
    1. Calvo C, Pacheco S, Hita E. Efficacy of deep dry needling on latent myofascial trigger points in older adults with non-specific shoulder pain: a randomized, controlled clinical trial pilot study. Journal of Geriatric Physical Therapy. 2015 doi: 10.1519/JPT.0000000000000048. Epub ahead of print March 15 2015.
    1. Calvo-Lobo C, Pacheco-da-Costa S, Martínez-Martínez J, Rodríguez-Sanz D, Cuesta-Álvaro P, López-López D. Dry needling on the infraspinatus latent and active myofascial trigger points in older adults with nonspecific shoulder pain: a randomized clinical trial. Journal of Geriatric Physical Therapy. 2016 doi: 10.1519/JPT.0000000000000079. Epub ahead of print Jan 15 2016.
    1. Celik D, Yeldan I. The relationship between latent trigger point and muscle strength in healthy subjects: a double-blind study. Journal of Back and Musculoskeletal Rehabilitation. 2011;24:251–256. doi: 10.3233/BMR-2011-0302.
    1. Chung AS, Copay A, Olmscheid N, Campbell D, Walker B, Chutkan N. Minimum clinically important difference: current trends in the spine literature. Spine. 2016 doi: 10.1097/BRS.0000000000001990. Epub ahead of print Nov 18 2016.
    1. Cole LJ, Farrell MJ, Gibson SJ, Egan GF. Age-related differences in pain sensitivity and regional brain activity evoked by noxious pressure. Neurobiology of Aging. 2010;31(3):494–503. doi: 10.1016/j.neurobiolaging.2008.04.012.
    1. Coronado RA, Simon CB, Valencia C, George SZ. Experimental pain responses support peripheral and central sensitization in patients with unilateral shoulder pain. The Clinical Journal of Pain. 2014;30:143–151.
    1. Cuesta-Vargas A, Hilgenkamp T. Reference values of grip strength measured with a jamar dynamometer in 1526 adults with intellectual disabilities and compared to adults without intellectual disability. PLOS ONE. 2015;10:e0129585. doi: 10.1371/journal.pone.0129585.
    1. Dhara PC, De S, Pal A, Sengupta P, Roy S. Assessment of hand grip strength of orthopedically challenged persons affected with upper extremity. Journal of Life Sciences. 2009;1:121–127.
    1. Dommerholt J, Hooks T, Finnegan M, Grieve R. A critical overview of the current myofascial pain literature—March 2016. Journal of Bodywork and Movement Therapies. 2016;20(2):397–408. doi: 10.1016/j.jbmt.2016.02.015.
    1. Donat H, Ozcan A, Ozdirenç M, Aksakoğlue G, Aydinoğlu S. Age-related changes in pressure pain threshold, grip strength and touch pressure threshold in upper extremities of older adults. Aging Clinical and Experimental Research. 2005;17:380–384. doi: 10.1007/BF03324626.
    1. Fernández-Carnero J, Fernández-de-Las-Peñas C, De la Llave-Rincón AI, Ge HY, Arendt-Nielsen L. Prevalence of and referred pain from myofascial trigger points in the forearm muscles in patients with lateral epicondylalgia. Clinical Journal of Pain. 2007;23:353–360. doi: 10.1097/AJP.0b013e31803b3785.
    1. Fisher A. Algometry in diagnosis of musculoskeletal pain and evaluation of treatment outcome: an update. Journal of Musculoskeletal Pain. 1998;6:5–32.
    1. Ge HY, Arendt-Nielsen L. Latent myofascial trigger points. Current Pain and Headache Reports. 2011;15:368–392. doi: 10.1007/s11916-011-0218-y.
    1. Ge HY, Fernández-de-las-Peñas C, Arendt-Nielsen L. Sympathetic facilitation of hyperalgesia evoked from myofascial tender and trigger points in patients with unilateral shoulder pain. Clinical Neurophysiology. 2006;117(7):1545–1550. doi: 10.1016/j.clinph.2006.03.026.
    1. Ge HY, Fernández-de-Las-Peñas C, Madeleine P, Arendt-Nielsen L. Topographical mapping and mechanical pain sensitivity of myofascial trigger points in the infraspinatus muscle. European Journal of Pain. 2008;12(7):859–865. doi: 10.1016/j.ejpain.2007.12.005.
    1. Gerber LH, Sikdar S, Armstrong K, Diao G, Heimur J, Kopecky J, Turo D, Otto P, Gebreab T, Shah J. A systematic comparison between subjects with no pain and pain associated with active myofascial trigger points. PM & R. 2013;5(11):931–938. doi: 10.1016/j.pmrj.2013.06.006.
    1. Gill TK, Shanahan EM, Allison D, Alcorn D, Hill CL. Prevalence of abnormalities on shoulder MRI in symptomatic and asymptomatic older adults. International Journal of Rheumatic Diseases. 2014;17:863–871. doi: 10.1111/1756-185X.12476.
    1. Hoch MC, Farwell KE, Gaven SL, Weinhandl JT. Weight-bearing dorsiflexion range of motion and landing biomechanics in individuals with chronic ankle instability. Journal of Athletic Training. 2015;50:833–839.
    1. Koo TK, Guo J, Brown CM. Test–retest reliability, repeatability and sensitivity of an automated deformation-controlled indentation on pressure pain threshold measurement. Journal of Manual and Manipulative Therapy. 2013;36:84–90. doi: 10.1016/j.jmpt.2013.01.001.
    1. Landi F, Russo A, Liperoti R, Danese P, Maiorana E, Pahor M, Bernabei R, Onder G. Daily pain and functional decline among old-old adults living in the community: results from the ilSIRENTE Study. Journal of Pain and Symptom Management. 2009;38:350–357. doi: 10.1016/j.jpainsymman.2008.10.005.
    1. Lautenbacher S, Kunz M, Strate P, Nielsen J, Arendt-Nielsen L. Age effects on pain thresholds, temporal summation and spatial summation of heat and pressure pain. Pain. 2005;115:410–418. doi: 10.1016/j.pain.2005.03.025.
    1. Lobo CC, Marín AG, Sanz DR, López DL, López PP, Morales CR, Corbalán IS. Ultrasound evaluation of intrinsic plantar muscles and fascia in hallux valgus: a case-control study. Medicine (Baltimore) 2016a;95(45):e5243. doi: 10.1097/MD.0000000000005243.
    1. Lobo CC, Morales CR, Sanz DR, Corbalán IS, Marín AG, López DL. Ultrasonography comparison of peroneus muscle cross-sectional area in subjects with or without lateral ankle sprains. Journal of Manipulative and Physiological Therapeutics. 2016b;39(9):635–644. doi: 10.1016/j.jmpt.2016.09.001.
    1. Mitchell C, Adebajo A, Hay E, Carr A. Shoulder pain: diagnosis and management in primary care. Clinical review. BMJ. 2005;331:1124–1128. doi: 10.1136/bmj.331.7525.1124.
    1. Myburgh C, Lauridsen HH, Larsen AH, Hartvigsen J. Standardized manual palpation of myofascial trigger points in relation to neck/shoulder pain; the influence of clinical experience on inter-examiner reproducibility. Manual Therapy. 2011;16:136–140. doi: 10.1016/j.math.2010.08.002.
    1. Neziri AY, Scaramozzino P, Andersen OK, Dickenson AH, Arendt-Nielsen L, Curatolo M. Reference values of mechanical and thermal pain tests in a pain-free population. European Journal of Pain. 2011;15:376–383. doi: 10.1016/j.ejpain.2010.08.011.
    1. Norman K, Stobäus N, Gonzalez MC, Schulzke JD, Pirlich M. Hand grip strength: outcome predictor and marker of nutritional status. Clinical Nutrition. 2011;30:135–142. doi: 10.1016/j.clnu.2010.09.010.
    1. Park G, Kim CD, Park SB, Kim MJ, Jang SH. Reliability and usefulness of the pressure pain threshold measurement in patients with myofascial pain. Annals of Rehabilitation Medicine. 2011;35:412–417. doi: 10.5535/arm.2011.35.3.412.
    1. Roberts HC, Denison HJ, Martin HJ, Patel HP, Syddall H, Cooper C, Sayer AA. A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age and Ageing. 2011;40:423–429. doi: 10.1093/ageing/afr051.
    1. Stratford PW, Goldsmith C. Use of the standard error as a reliability index of interest: an applied example using elbow flexor strength data. Physical Therapy. 1977;77:745–750.
    1. Taylor LJ, Harris J, Epps C, Herr K. Psychometric evaluation of selected pain intensity scales for use in cognitively impaired and cognitively intact older adults. Rehabilitation Nursing. 2005;30:55–61. doi: 10.1002/j.2048-7940.2005.tb00360.x.
    1. Von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Annals of Internal Medicine. 2007;147:573–577. doi: 10.7326/0003-4819-147-8-200710160-00010.
    1. Zhou S, Kemp J, Després O, Pebayle T, Dufour A. The association between inhibition and pain tolerance in the elderly: evidence from event-related potentials. European Journal of Pain. 2015;19:669–676. doi: 10.1002/ejp.588.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere