Premium
Interobserver agreement of medical research council sum‐score and handgrip strength in the intensive care unit
Author(s) -
Hermans Greet,
Clerckx Beatrickx,
Vanhullebusch Tine,
Segers Johan,
Vanpee Goele,
Robbeets Christophe,
Casaer Michael Paul,
Wouters Pieter,
Gosselink Rik,
Van Den Berghe Greet
Publication year - 2012
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.22219
Subject(s) - intraclass correlation , medicine , weakness , muscle weakness , limits of agreement , physical therapy , intensive care unit , physical medicine and rehabilitation , surgery , nuclear medicine , psychometrics , clinical psychology
Muscle weakness often complicates critical illness and is associated with devastating short‐ and long‐term consequences. For interventional studies, reliable measurements of muscle force in the intensive care unit (ICU) are needed. Methods: To examine interobserver agreement, two observers independently measured Medical Research Council (MRC) sum‐score ( n = 75) and handgrip strength ( n = 46) in a cross‐sectional ICU sample. Results: The intraclass correlation coefficient (ICC) for MRC sum‐score was 0.95 (0.92–0.97). The kappa coefficient for identifying “significant weakness” (MRC sum‐score <48, MRC subtotal upper limbs <24) and “severe weakness” (MRC sum‐score <36) was 0.68 ± 0.09, 0.88 ± 0.07, and 0.93 ± 0.07, respectively. The ICC for left and right handgrip strength was 0.97 (0.94–0.98) and 0.93 (0.86–0.97), respectively. Conclusions: Interobserver agreement on MRC sum‐score and handgrip strength in the ICU was very good. Agreement on “severe weakness” (MRC sum‐score <36) was excellent and supports its use in interventional studies. Agreement on “significant weakness” (MRC sum‐score <48) was good, but even better using the equivalent cut‐off in the upper limbs. It remains to be determined whether this may serve as a substitute. Muscle Nerve 45: 18–25, 2012