Hand grip strength as a clinical biomarker for ME/CFS, 2018, Nacul et al

adambeyoncelowe said:
I believe more tests were done. One of the trial subjects mentioned she had five tests upthread. It may just be that three tests are required to spot the change?
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If you are referring to my post I was not part of the trial. I had these tests as part of a medical assessment for an insurance claim.
I had no idea why this was the only physical test they did and apart from reporting the results they made no comments on conclusions from them, so fairly pointless for the assessment.
 
Sbag said:
If you are referring to my post I was not part of the trial. I had these tests as part of a medical assessment for an insurance claim.
I had no idea why this was the only physical test they did and apart from reporting the results they made no comments on conclusions from them, so fairly pointless for the assessment.
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Ah! My mistake. I thought you were part of the trial. Info just isn't sinking in properly this week, evidently!
 
Trish said:
Having bought myself a hand grip gauge, I'm now too scared to test myself. What if I don't get a decrease in grip strength over a series of tests - does that mean I don't have ME? :unsure:
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I don't think it would conclusively rule it out. It seems to me that this is just a test to back up claims of weakness or rapid fatiguability after activity. It's not diagnostic alone, but may back up certain self-reported symptoms.
 
Trish said:
Having bought myself a hand grip gauge, I'm now too scared to test myself. What if I don't get a decrease in grip strength over a series of tests - does that mean I don't have ME? :unsure:
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Hmm. A bit inconclusive.

I had a go with both hands. One hand it dropped from first to second then stayed the same for the third, the other hand it dropped for the first and then went up a bit for the third.

I then rested for an hour and tried again. This time it dropped for both hands at first to second and second to third, though oddly the starting point for one hand was significantly higher than an hour earlier.

Definitely some sign of decrease, but not clear cut every time as they describe. Makes me wonder if I'm doing it right.

The one definite thing I can report. It ramped up the pain in my arm muscles - they are still aching and burning half an hour later and my hands feel shaky typing this.
 
Trish said:
Hmm. A bit inconclusive.

I had a go with both hands. One hand it dropped from first to second then stayed the same for the third, the other hand it dropped for the first and then went up a bit for the third.

I then rested for an hour and tried again. This time it dropped for both hands at first to second and second to third, though oddly the starting point for one hand was significantly higher than an hour earlier.

Definitely some sign of decrease, but not clear cut every time as they describe. Makes me wonder if I'm doing it right.

The one definite thing I can report. It ramped up the pain in my arm muscles - they are still aching and burning half an hour later and my hands feel shaky typing this.
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That sounds like it's still a positive result, though? The drop appears to be primarily between first and second test.
 
adambeyoncelowe said:
That sounds like it's still a positive result, though? The drop appears to be primarily between first and second test.
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The main conclusion I've drawn is that I'm not sure I'm doing it right.

Since I got a wider variation doing it at different times of the day, or different days, than I got within one sequence of 3 tests I'm left confused and concluding I don't really know what I'm doing!
 
It's M.E. Linda said:
This was using my dominant hand and I could have sworn that I had gripped harder on the 2nd and 3rd times, having got used to how the machine felt in my hand.
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This is how it feels to me when I do a lung muscle strength test. I feel like I am blowing out harder as I try to match the volume from the first repetition, but the graph looks worse. They send my doctor the first or very occasionally the second one.

They always seem to think I would do a lot better on repetition (as it's kind of bad), but I can't. I try very hard.
 
WillowJ said:
This is how it feels to me when I do a lung muscle strength test. I feel like I am blowing out harder as I try to match the volume from the first repetition, but the graph looks worse. They send my doctor the first or very occasionally the second one.

They always seem to think I would do a lot better on repetition (as it's kind of bad), but I can't. I try very hard.
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This is the same for me also. That for me is a very difficult test. I very rarely get a decent result even for the first one, but i usually feel that i’m trying harder on 2nd or 3rd go even though results show the opposite.
 
Wondering if it's possible to replicate this study by including this seemingly very simple test in as many trials on ME as possible?

E.g. to compare the results of the handgrip test at both days of the 2-day CPET? (Could it measure PEM?)
 
Only just picking up this thread again. When I gave my sample to the Biobank a couple of months ago, Caroline did the grip test as part of the collection. She did 3 tests and said after looking at my drop in strength on the second that I was typical ME. She said that in most cases healthy controls do get a stronger result on the second test as they get used to the feel of the thing.

Looks like they are continuing to collect results on this so it seems to be an aid to diagnosis rather than anything definitive.
 
So I've just received a dynamometer through the post. Out of curiosity, I tried this. I got 28.5, 20.9 and 20.3.

If you keep doing it several times in a row, there does appear to be a training effect on that first result only (i.e., that first reading goes up slightly, although there's still a similar drop between that and later results).

Also, I think the paper says to hold for three seconds per test. Holding longer than this skews the numbers higher (I tried later on and got over 30 doing that). However, doing it for such a short period of time certainly makes it harder to fake the results (there isn't the time to consciously adjust grip).

The hardest thing is getting your arm in the right position without help. This is where a nurse would come in.

All my results were below 'weak' for my age and gender, which I knew already, but I am going to monitor this to see if it leads to any objective changes on days where my fatigue is worse.
 
It will be interesting to see how it goes for you. I gave up on it after enthusiastically trying it several times in a day. The pain and weakness in my arm and hand hung around into the next day. I recommend not doing it often!
 
Trish said:
It will be interesting to see how it goes for you. I gave up on it after enthusiastically trying it several times in a day. The pain and weakness in my arm and hand hung around into the next day. I recommend not doing it often!
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I think one might eliminate the clear drop in results if they repeated the protocol too closely together. That first test has to be after enough of a rest for your muscle strength to have returned, I imagine?

I tried to let my muscles properly recover between each attempt (not between each of the three tests, however, as the protocol specifically only lets you wait 30 seconds between them), although it's hard to be sure.

Later in the day I did it again and got 27.7, 20, 21.2. I tried it in the evening and got 31.8, 26.7 and 28.2. Interestingly, I was much less fatigued in the evening than the day (I wake up a bit at night).

I'm going to try it again today by some point.
 
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