Do Grip and Pinch Strength Predict Neurologic Complications in Children with Spina Bifida and Hydrocephalus?

Abstract

Background: Neurological complications occur commonly in children with meningomyelocele and can cause significant morbidity and mortality. An earlier study suggested that acute changes in grip and pinch strength could be used to identify individuals at increased risk for developing a neurological complication. Objective: To evaluate the use of grip and pinch measurements to screen for neurological problems in children with spina bifida and hydrocephalus. Design: A prospective evaluation of screening tests. Patients: 92 children, born since 1976, who had meningomyelocele and hydrocephalus and were treated at the University of Rochester Medical Center. Methods: Grip and pinch strength were measured between July, 1991, and June, 2003. Results: Mean grip and pinch strengths were similar to those found in previous studies of children with meningomyelocele; 58 neurological events occurred in 39 (40%) individuals. These included 31 episodes of ventricular shunt failure and 22 symptomatic tethered cord occurrences. Specificity, sensitivity and likelihood ratios were calculated in multiple ways using different criteria for loss of grip or pinch strength and for interval to neurological event. Sensitivities were low (<0.35) and the highest positive likelihood ratio found, using fall in either lateral pinch with 6 months to neurological event, was 2.3. Conclusions: Despite previous recommendations, grip and pinch measurements were not helpful when used as a routine screening test for neurological dysfunction for children with meningomyelocele and hydrocephalus.

Desempenho funcional de crianças com mielomeningocele

“…Está associada a freqüentes e severas seqüe-las neurológicas 3 , que podem causar significativa morbidade e mortalidade 4 . Prevalências altas em centros de referência refletem os progressos no diagnóstico e a disponibilidade de equipes capacitadas para tratar essa malformação e suas conseqüências 5 .…”

Hand anthropometry and its relation to grip/pinch strength in children aged 5 to 13 years

“…As a simple and economical method, measurement of grip and pinch strength can not only reflect the development of hand function but also serve as an auxiliary monitoring method for the development of various systems throughout the whole body; thus, measurement of grip and pinch strength has been receiving increasingly more attention. 5 , 17 Research on grip strength and pinch strength is performed not only to evaluate strength but also to comprehensively evaluate children’s health condition, allowing the physical examination findings to better serve the ultimate goal of promoting health. Therefore, research on the development of grip and pinch strength is also very important to fully understand the development of children’s hand function.…”