HSR21-053: Identifying Clinically Important Changes of Grip Strength Over Time in Patients With Hematological Malignancy

Authors: Beth E. Hunt PT, DPT1, Amy M. Yochem PT, DPT1, Kate Minick PhD, PT, DPT, OCS1, and Gerard Brennan PhD, PT, DPT, FAPTA1
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  • 1 Intermountain Healthcare, Salt Lake City, UT

Patients undergoing treatment for hematological malignancy typically experience strength changes that can negatively impact their overall physical function. The Minimal Clinically Importance Difference (MCID) can be used to determine if meaningful improvement has been made with treatment. No evidence exists for MCIDs of grip strength for older patients with cancer. The purpose of this descriptive study is to identify grip strength changes over time for older patients undergoing treatment for hematological malignancy. Our hypothesis is that meaningful change of grip strength for is detected between initial baseline week 1 and week 5+ during an inpatient admission. 794 patient encounters between the ages of 50-79 who were admitted to the inpatient setting for transplant or non-transplant with a diagnosis of a hematological malignancy including leukemia, lymphoma, or multiple myeloma were retrospectively examined. Grip strength that were taken one time per week were collected at weeks 1, 2, 3, 4 and 5+ during their admission and included in the analysis. A repeated measures ANOVA was used to determine the difference in measurements of grip strength during the episode of care. A difference was detected for grip strength between weeks 1, 2, 3, 4, 5+ on the left (f -ratio value 3.91, p -value .007236, p< .05). A difference was detected between grip strengths between weeks 1, 2, 3, 4, 5+ on the right (f- ratio value is 4.07, p- value is .006729, p< .05). Mean grip strength on the right for weeks 1-5+ was between 44.21lbs and 58.60lb. On average for right grip strength there was a 2.66lb change was between weeks 1 and 2, a 3.94lb change between weeks 1 and 3, a 2.48lb change between weeks 1 and 4, and a 10.45lb change between weeks 1 and 5. Mean grip strength on the left between weeks 1-5+ was 42.54lbs and 56lbs. On average a 1.22lb change was between weeks 1 and 2, a 3.69lb change between weeks 1 and 3, a 1.81lb change between weeks 1 and 4, and a 9.72lb change between weeks 1 and 5. Grip strength is predominately greater on the right versus the left and both upwardly trend until week 3. At week 3, grip strength peaks and declines in weeks 4 and 5+. Grip strength changes over time during an inpatient hospital admission and declines if a patient has a stay longer than 3 weeks. This highlights that a difference exists in grip strength and may impact how patients’ physical function could be adversely impacted.

Corresponding Author: Beth E. Hunt, PT, DPT
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