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Handgrip Strength is a Reliable Outcome Measure and is Associated with Inspiratory Muscle Strength and Exercise Capacity in Hemodialysis Patients

Pedro Henrique Scheidt Figueiredo, Gabriela de Araújo Nominato, Jousielle Márcia dos Santos, Márcia Maria Oliveira Lima, Frederico Lopes Alves, Vanessa Gomes Brandão Rodrigues, Emílio Henrique Barroso Maciel, Maria Cecília Sales Mendes Prates, Vanessa Pereira Lima, Vanessa Amaral Mendonça, Ana Cristina Ro

Objective: To determine the reliability of the handgrip strength (HGS) and to evaluate the association between HGS, inspiratory muscle strength and exercise capacity (EC) in hemodialysis patients.

Methods: Hemodialysis patients performed HGS, maximal inspiratory pressure, and Incremental Shuttle Walking Test (ISWT) for EC evaluation. The data obtained from the ISWT were divided into tertiles, and the HGS results were compared among tertiles using analysis of variance. Reliability analyses were assessed by intra-class correlation coefficient (ICC) and minimal detectable change at the 90% CI (MDC90). Associations were determined by linear regression analysis.

Results: Thirty-six hemodialysis patients aged 49.1 years (95% CI 44.0–54.1) were evaluated. HGS presented excellent reliability (ICC=0.98) and MDC90 was 3.1 kg. HGS and age were the independent predictors to maximal inspiratory pressure and EC (R2 adjusted=0.52 and 0.42, respectively). Patients with inspiratory muscle weakness had lower HGS values [difference of 8.6 kg (95% CI 0.5–16.7]. Tertile 1 of the ISWT was different from tertile 2 for HGS [difference of 13.4 kg (95% CI 4.7–22.1)], as well as from tertile 3 [difference of 13.9 kg (95% CI 5.2–22.6)].

Conclusion: HGS is a reliable outcome measure and is directly related to the inspiratory muscle strength and EC in hemodialysis patients.