Inter-rater reliability of manual muscle strength testing in ICU survivors and simulated patients
Open accessAbstract
Objective The goal of the paper is to determine inter-rater reliability of trained examiners performing standardized strength assessments using manual muscle testing (MMT). Design, subjects, and setting The authors report on 19 trainees undergoing quality assurance within a multi-site prospective cohort study. Intervention Inter-rater reliability for specially trained evaluators ("trainees") and a reference rater, performing MMT using both simulated and actual patients recovering from critical illness was evaluated. Measurements and results Across 26 muscle groups tested by 19 trainee-reference rater pairs, the median (interquartile range) percent agreement and intraclass correlation coefficient (ICC; 95% CI) were: 96% (91, 98%) and 0.98 (0.95, 1.00), respectively. Across all 19 pairs, the ICC (95% CI) for the overall composite MMT score was 0.99 (0.98-1.00). When limited to actual patients, the ICC was 1.00 (95% CI 0.99-1.00). The agreement (kappa; 95% CI) in detecting clinically significant weakness was 0.88 (0.44-1.00). Conclusions MMT has excellent inter-rater reliability in trained examiners and is a reliable method of comprehensively assessing muscle strength.
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Handgrip dynamometry can assess muscle function.
“Handgrip dynamometry can assess muscle function [23].”
From ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit (2023) · cites this paper as [23]
The Methods section (“Manual muscle strength testing,” page unavailable) describes scoring muscle strength with the Medical Research Council scale, and the Discussion addresses manual muscle testing. Searches for “handgrip dynamometry” and grip strength measured with a dynamometer found no passage in our copy stating that handgrip dynamometry can assess muscle function. (LLM, conf=0.75)
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ESPEN guideline on clinical nutrition in the intensive care unit.
Singer, P., Blaser, A. R., Berger, M. M., Alhazzani, W., Calder, P. C., Casaer, M. P., Hiesmayr, M., Mayer, K., Montejo, J. C., Pichard, C., et al. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2018.08.037 · Cited by 2,904 · see citing works
ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit
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Physical Complications in Acute Lung Injury Survivors: A Two-Year Longitudinal Prospective Study
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Connolly, B., Denehy, L., Brett, S., Elliott, D., & Hart, N. (2012) · Critical Care · doi:10.1186/cc11219 · Cited by 49 · see citing works
- Authors
- Fan, E., Ciesla, N. D., Truong, A. D., Bhoopathi, V., Zeger, S. L., & Needham, D. M.
- Affiliations
- Johns Hopkins University (US)
- Boston University (US)
- Corresponding author
- Fan, Eddy
- Venue
- Intensive Care Medicine
- Published
- 2010-03-06
- Volume
- 36
- Issue
- 6
- Pages
- 1038-1043
- ISSN
- 0342-4642 (ISSN-L)
- 1432-1238
- PMC
- PMC2891143
- OpenAlex
- W1967470019
- Cited by
- 162
- References
- 2
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 8 · 2023: 6 · 2022: 15 · 2021: 8 · 2020: 11 · 2019: 11 · 2018: 8 · 2017: 9 · 2016: 16 · 2015: 15 · 2014: 7 · 2013: 7 · 2012: 16
- FWCI
- 12.94
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Intensive Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Royal College of Physicians and Surgeons of Canada
- National Institutes of Health (5p50hl073994-05)
- Canadian Institutes of Health Research
- Medical Research Council
- National Heart, Lung, and Blood Institute (P50 HL-073994, P50 HL73994, K24HL088551)
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Reliability and Agreement in Measurement
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- manual muscle testing, inter-rater reliability, intensive care unit survivors, standardized patients, critical illness, muscle strength assessment, quality assurance
- MeSH terms
- Humans, Intensive Care Units, Physical Examination, Prospective Studies, Reproducibility of Results, Cohort Studies, Observer Variation, Patient Simulation, Survivors, Muscle Strength
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