| Resumo: |
Several studies demonstrated that Handgrip Strength (HGS) can be used as a nutritional assessment technique, also sensitive in evaluating short-term changes in nutritional status, being associated with higher long term mortality. HGS is also useful for the detection of functional status and in the onset of activities of daily living dependence in the elderly.
To investigate if HGS could be used as a single screening procedure in identifying patients who are classified as being undernourished at health care departments, we previously used a probabilistic sample of 50% in-patients from two hospitals (n=314). HGS identified a high proportion of nutritionally-at-risk patients, being strongly and inversely related with nutritional risk, suggesting that HGS can be a reliable first screening tool for nutritional risk.
As a nutritional screening method, HGS contrasts with other tools. The handheld dynamometer is non invasive, quick and easy to use, portable and rather inexpensive, has a relatively low observer and intra-individual variability and does not require skilled technicians. Another advantage of HGS, is that patients do not need to be weighed and therefore allowing the screening of patients with fluid retention. Zero or extremely low HGS values that we obtained previously in undernourished patients, advocates the development of more sensitive and ergonomic dynamometers for the health care setting. Further research is also needed in order to confirm the screening cut points.
Regarding the development of a novel Handgrip (HS) device it is envisaged the need of a new design over existing apparatus taking into consideration the following objectives:
Small size - Portability and small size is not commonly found in most of the existing commercial handgrips that are rather cumbersome. These requirements and the intended use of an electronic sensor, implies battery operation with overall low energy consumption;
Comfortable handling - Intended for use on adult o  |
Resumo
Several studies demonstrated that Handgrip Strength (HGS) can be used as a nutritional assessment technique, also sensitive in evaluating short-term changes in nutritional status, being associated with higher long term mortality. HGS is also useful for the detection of functional status and in the onset of activities of daily living dependence in the elderly.
To investigate if HGS could be used as a single screening procedure in identifying patients who are classified as being undernourished at health care departments, we previously used a probabilistic sample of 50% in-patients from two hospitals (n=314). HGS identified a high proportion of nutritionally-at-risk patients, being strongly and inversely related with nutritional risk, suggesting that HGS can be a reliable first screening tool for nutritional risk.
As a nutritional screening method, HGS contrasts with other tools. The handheld dynamometer is non invasive, quick and easy to use, portable and rather inexpensive, has a relatively low observer and intra-individual variability and does not require skilled technicians. Another advantage of HGS, is that patients do not need to be weighed and therefore allowing the screening of patients with fluid retention. Zero or extremely low HGS values that we obtained previously in undernourished patients, advocates the development of more sensitive and ergonomic dynamometers for the health care setting. Further research is also needed in order to confirm the screening cut points.
Regarding the development of a novel Handgrip (HS) device it is envisaged the need of a new design over existing apparatus taking into consideration the following objectives:
Small size - Portability and small size is not commonly found in most of the existing commercial handgrips that are rather cumbersome. These requirements and the intended use of an electronic sensor, implies battery operation with overall low energy consumption;
Comfortable handling - Intended for use on adult or elderly undernourished patients, the commercially
available HG have an uncomfortable use, thus affecting a correct force evaluation. To meet the special needs of the target population, soft material pads with an anatomical design should be used;
Low weight and high strength - The use of this type of HG by target user requires a low weight device, the use of light metal alloys or/and composite fibber materials is envisaged reducing the risk of com mom accidents in daily operation;
Easily adapted to hand anatomy - When using the current dynamometers, large anatomic variation of
patient hands results in undesirable measurement errors of gripping force. In a new design a variable grip adaptation will be considered to solve this problem;
Capacity to read low and high gripping forces with adjusted resolution - Because de majority of HG devices are made to be used in sportive medicine fields, the force sensibility of these devices makes them inadequate to measure low-level forces. To solve this problem it's necessary to develop a sensor device capable of measuring in a wide range of values;
Low/No maintenance - The health care environment where the HG devices will be used is not suitable for frequent maintenance or calibration, which implies a robust design of the sensing system as well as the complementary electronics involved;
Low cost - The commercially available HG devices don't correspond to the aims previously determined and have also the disadvantage of being very expensive. This represents an obstacle to their applicability as a screening method in the clinical setting. For this reason, a low cost solution must be an imperative objective to be present at the different phases of the development. |