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

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          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/cm 2; P < .001), ECRB PPT (2.20 ± 0.60 vs 3.35 ± 0.38 kg/cm 2; 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/cm 2, 1.15 kg/cm 2 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.

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          Most cited references27

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          Hand grip strength: outcome predictor and marker of nutritional status.

          Among all muscle function tests, measurement of hand grip strength has gained attention as a simple, non-invasive marker of muscle strength of upper extremities, well suitable for clinical use. This review outlines the prognostic relevance of grip strength in various clinical and epidemiologic settings and investigates its suitability as marker of nutritional status in cross-sectional as well as intervention studies. Studies investigating grip strength as prognostic marker or nutritional parameter in cross-sectional or intervention studies were summarized. Numerous clinical and epidemiological studies have shown the predictive potential of hand grip strength regarding short and long-term mortality and morbidity. In patients, impaired grip strength is an indicator of increased postoperative complications, increased length of hospitalization, higher rehospitalisation rate and decreased physical status. In elderly in particular, loss of grip strength implies loss of independence. Epidemiological studies have moreover demonstrated that low grip strength in healthy adults predicts increased risk of functional limitations and disability in higher age as well as all-cause mortality. As muscle function reacts early to nutritional deprivation, hand grip strength has also become a popular marker of nutritional status and is increasingly being employed as outcome variable in nutritional intervention studies. Copyright © 2010 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
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            Hand-grip dynamometry predicts future outcomes in aging adults.

            One use of clinical measures is the prediction of future outcomes. The purpose of this systematic review was to summarize the literature addressing the value of grip strength as a predictor of important outcomes. Relevant literature was located using 4 bibliographic databases, searching article reference lists, and perusing personal files. Forty-five relevant research articles were found. The research involved both healthy subjects and patients; it tended to focus on middle-aged and older adults. The primary outcome addressed was mortality/survival (24 articles), but disability (9 articles), complications and/or increased length of stay (12 articles), and other outcomes were also examined. Low grip strength was shown consistently to be associated with a greater likelihood of premature mortality, the development of disability, and an increased risk of complications or prolonged length of stay after hospitalization or surgery. Given its predictive validity and simplicity, dynamometrically measured grip strength should be considered as a vital sign useful for screening middle-aged and older adults.
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              • Article: not found

              Shoulder pain: diagnosis and management in primary care.

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                Author and article information

                Contributors
                Journal
                PeerJ
                PeerJ
                peerj
                peerj
                PeerJ
                PeerJ Inc. (San Francisco, USA )
                2167-8359
                9 February 2017
                2017
                : 5
                : e2995
                Affiliations
                [1 ]Physiotherapy Department, Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid , Madrid, Spain
                [2 ]Physical Therapy & Health Sciences Research Group, Physiotherapy Department, Faculty of Health, Exercise and Sport, European University , Madrid, Spain
                [3 ]School of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid , Madrid, Spain
                [4 ]Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University , Madrid, Spain
                [5 ]Research Group on Movement and Behavioural Science and Study of Pain, The Center for Advanced Studies University La Salle, Autónoma University , Madrid, Spain
                [6 ]La Paz Hospital Institute for Health Research, IdiPAZ , Madrid, Spain
                [7 ]Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña , Ferrol, A Coruña, Spain
                Article
                2995
                10.7717/peerj.2995
                5345821
                28289561
                aa52b57f-f285-4b77-9014-5cc5b3e7a737
                ©2017 Calvo Lobo et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited.

                History
                : 22 November 2016
                : 16 January 2017
                Funding
                The authors received no funding for this work.
                Categories
                Geriatrics
                Orthopedics
                Rheumatology

                shoulder pain,myofascial pain syndromes,referred pain,aged,trigger points,hand strength

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