The value of the isometric hand-grip test - Studies in various autonomic disorders

Ramesh Khurana, A. Setty

Research output: Contribution to journalArticle

Abstract

Time-related methodological differences have confounded the value of isometric hand-grip (IHG) exercise as a test of sympathetic function. This study examines the blood pressure response to IHG in 71 normal subjects and 76 dysautonomic patients and compares it with the tilt table test. All participants were supine and performed IHG at 30% of maximum contraction for 5 min. Change in diastolic blood pressure (DBP) was the most sensitive and specific measurement in diagnosing abnormals. The multivariate group by time (1-5 min) effect was significant (F = 10.14, p < 0.001) with 5 min as the most important time measurement (Wilk's lambda = 0.70, p < 0.001). The DPB rise for normals was 25.15 ± 1.31 mmHg (mean ± SE), range 22.55-27.76 mmHg, with a sensitivity of 78.95% and a specificity of 71.83%. A multivariate analysis of variance showed intraindividual reproducibility of nine normals over four trials (F = 0.950, p > 0.25). Gender and grip strength were additional important variables. In comparison, the tilt table test demonstrated a sensitivity of 82.76% and a specificity of 73.68%. Isometric hand-grip is therefore a specific, sensitive, reproducible, simple and non-invasive test of sympathetic function with relatively well-studied reflex pathways. Its sensitivity and specificity compare favourably with the tilt table test. It should be incorporated in routine autonomic testing.

Original languageEnglish (US)
Pages (from-to)211-218
Number of pages8
JournalClinical Autonomic Research
Volume6
Issue number4
DOIs
StatePublished - Oct 29 1996
Externally publishedYes

Fingerprint

Hand Strength
Tilt-Table Test
Hand
Blood Pressure
Reflex
Exercise
Sensitivity and Specificity

Keywords

  • Diastolic blood pressure
  • Isometric hand-grip
  • Neural pathways
  • Sympathetic function

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

The value of the isometric hand-grip test - Studies in various autonomic disorders. / Khurana, Ramesh; Setty, A.

In: Clinical Autonomic Research, Vol. 6, No. 4, 29.10.1996, p. 211-218.

Research output: Contribution to journalArticle

@article{26839b8f0b1344f99ed79c14d6ea0933,
title = "The value of the isometric hand-grip test - Studies in various autonomic disorders",
abstract = "Time-related methodological differences have confounded the value of isometric hand-grip (IHG) exercise as a test of sympathetic function. This study examines the blood pressure response to IHG in 71 normal subjects and 76 dysautonomic patients and compares it with the tilt table test. All participants were supine and performed IHG at 30{\%} of maximum contraction for 5 min. Change in diastolic blood pressure (DBP) was the most sensitive and specific measurement in diagnosing abnormals. The multivariate group by time (1-5 min) effect was significant (F = 10.14, p < 0.001) with 5 min as the most important time measurement (Wilk's lambda = 0.70, p < 0.001). The DPB rise for normals was 25.15 ± 1.31 mmHg (mean ± SE), range 22.55-27.76 mmHg, with a sensitivity of 78.95{\%} and a specificity of 71.83{\%}. A multivariate analysis of variance showed intraindividual reproducibility of nine normals over four trials (F = 0.950, p > 0.25). Gender and grip strength were additional important variables. In comparison, the tilt table test demonstrated a sensitivity of 82.76{\%} and a specificity of 73.68{\%}. Isometric hand-grip is therefore a specific, sensitive, reproducible, simple and non-invasive test of sympathetic function with relatively well-studied reflex pathways. Its sensitivity and specificity compare favourably with the tilt table test. It should be incorporated in routine autonomic testing.",
keywords = "Diastolic blood pressure, Isometric hand-grip, Neural pathways, Sympathetic function",
author = "Ramesh Khurana and A. Setty",
year = "1996",
month = "10",
day = "29",
doi = "10.1007/BF02291136",
language = "English (US)",
volume = "6",
pages = "211--218",
journal = "Clinical Autonomic Research",
issn = "0959-9851",
publisher = "D. Steinkopff-Verlag",
number = "4",

}

TY - JOUR

T1 - The value of the isometric hand-grip test - Studies in various autonomic disorders

AU - Khurana, Ramesh

AU - Setty, A.

PY - 1996/10/29

Y1 - 1996/10/29

N2 - Time-related methodological differences have confounded the value of isometric hand-grip (IHG) exercise as a test of sympathetic function. This study examines the blood pressure response to IHG in 71 normal subjects and 76 dysautonomic patients and compares it with the tilt table test. All participants were supine and performed IHG at 30% of maximum contraction for 5 min. Change in diastolic blood pressure (DBP) was the most sensitive and specific measurement in diagnosing abnormals. The multivariate group by time (1-5 min) effect was significant (F = 10.14, p < 0.001) with 5 min as the most important time measurement (Wilk's lambda = 0.70, p < 0.001). The DPB rise for normals was 25.15 ± 1.31 mmHg (mean ± SE), range 22.55-27.76 mmHg, with a sensitivity of 78.95% and a specificity of 71.83%. A multivariate analysis of variance showed intraindividual reproducibility of nine normals over four trials (F = 0.950, p > 0.25). Gender and grip strength were additional important variables. In comparison, the tilt table test demonstrated a sensitivity of 82.76% and a specificity of 73.68%. Isometric hand-grip is therefore a specific, sensitive, reproducible, simple and non-invasive test of sympathetic function with relatively well-studied reflex pathways. Its sensitivity and specificity compare favourably with the tilt table test. It should be incorporated in routine autonomic testing.

AB - Time-related methodological differences have confounded the value of isometric hand-grip (IHG) exercise as a test of sympathetic function. This study examines the blood pressure response to IHG in 71 normal subjects and 76 dysautonomic patients and compares it with the tilt table test. All participants were supine and performed IHG at 30% of maximum contraction for 5 min. Change in diastolic blood pressure (DBP) was the most sensitive and specific measurement in diagnosing abnormals. The multivariate group by time (1-5 min) effect was significant (F = 10.14, p < 0.001) with 5 min as the most important time measurement (Wilk's lambda = 0.70, p < 0.001). The DPB rise for normals was 25.15 ± 1.31 mmHg (mean ± SE), range 22.55-27.76 mmHg, with a sensitivity of 78.95% and a specificity of 71.83%. A multivariate analysis of variance showed intraindividual reproducibility of nine normals over four trials (F = 0.950, p > 0.25). Gender and grip strength were additional important variables. In comparison, the tilt table test demonstrated a sensitivity of 82.76% and a specificity of 73.68%. Isometric hand-grip is therefore a specific, sensitive, reproducible, simple and non-invasive test of sympathetic function with relatively well-studied reflex pathways. Its sensitivity and specificity compare favourably with the tilt table test. It should be incorporated in routine autonomic testing.

KW - Diastolic blood pressure

KW - Isometric hand-grip

KW - Neural pathways

KW - Sympathetic function

UR - http://www.scopus.com/inward/record.url?scp=0029958734&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029958734&partnerID=8YFLogxK

U2 - 10.1007/BF02291136

DO - 10.1007/BF02291136

M3 - Article

C2 - 8902317

AN - SCOPUS:0029958734

VL - 6

SP - 211

EP - 218

JO - Clinical Autonomic Research

JF - Clinical Autonomic Research

SN - 0959-9851

IS - 4

ER -