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

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.

 

Ah! My mistake. I thought you were part of the trial. Info just isn't sinking in properly this week, evidently!

 

Me too, but hadn't thought of it that way before.

 

I don't think so. That's what I meant above that, maybe, the repetitions aren't enough. But I bet @Trish that you'll make an interesting observation just do it, and if you're willing to share - at least I'm already curious.

 

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.

 

That sounds like it's still a positive result, though? The drop appears to be primarily between first and second test.

 

I’m going to buy one of these next week hopefully and give it a go. Maybe keep a diary over a month

 

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.

 

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.

 

But in which case how can it discriminate between ME and other fatiguing illnesses? There must be so many conditions where hand grip strength falls off.

 

I think the word biomarker is being overused. It's a clinical sign surely, and disproves Weasely words about muscles.

 

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.

 

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.