Correlação entre força de preensão manual e fatores demográficos, clínicos e funcionais em indivíduos com sequelas de acidente vascular cerebral: um estudo observacional transversal com grupo controle
DOI:
https://doi.org/10.11606/issn.23170190.v33e244110Palavras-chave:
Dinamometria Manual, Sistema Único de Saúde, Força da Mão, ReabilitaçãoResumo
Objetivo: Determinar a existência de correlações entre a Força de Preensão Manual (FPM) de indivíduos com sequelas de acidente vascular cerebral (AVC) com variáveis demográficas, clínicas e funcionais. Método: Estudo observacional, transversal, com grupo controle, pautado na avaliação dos dados de 92 pacientes (mulheres: 56%; idade média: 56 anos), com sequelas de AVC, em regime de internação, em um centro de reabilitação de saúde pública brasileiro, na conjuntura de atendimentos multidisciplinar. Para fins de comparação, foi formado um grupo controle com 115 participantes saudáveis (mulheres: 66%; idade média: 39 anos). As avaliações foram feitas por meio de protocolos padronizados e avaliadores treinados. Resultados: O modelo final de regressão (r²= 0.54) demonstra que o sexo (p <0.0001), a idade (p <0.0129) e o escore da Medida de Independência Funcional (MIF) (p <0.0002) são as variáveis que mais explicam as variações da FPM entre os pacientes com sequelas de AVC. Conclusão: A análise das correlações entre a FPM e variáveis demográficas, clínicos e funcionais, consolida a FPM como um indicador vital para guiar estratégias terapêuticas e monitorar a recuperação da autonomia em pacientes pós-AVC.
Downloads
Referências
GBD 2021 Nervous System Disorders Collaborators. Global, regional, and national burden of disorders affecting the nervous system, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Neurol. 2024;23(4):344-381. Doi: https://doi.org/10.1016/S1474-4422(24)00038-3
Maramélia M. Números do AVC [Internet]. Sociedade Brasileira de AVC (SBAVC); 2024 [cited 2025 May 5]. Available from: https://avc.org.br/numeros-do-avc
Reis MF, Chaoubah A. Gastos do Sistema Único de Saúde e do Regime Geral de Previdência Social com o acidente vascular cerebral: Brasil, 2020. REAS. 2024;24(2):e14884. Doi: https://doi.org/10.25248/reas.e14884.2024
Zhang Y, Chen W, Cao B, Lin L, Li J, Guo VY. Associations of handgrip weakness and asymmetry with new-onset stroke in Chinese middle-aged and older adults: a cohort study. Front Public Health. 2023;11:1251262. Doi: https://doi.org/10.3389/fpubh.2023.1251262
Wlodarczyk L, Szelenberger R, Cichon N, Saluk-Bijak J, Bijak M, Miller E. Biomarkers of Angiogenesis and Neuroplasticity as Promising Clinical Tools for Stroke Recovery Evaluation. Int J Mol Sci. 2021;22(8):3949. Doi: https://doi.org/10.3390/ijms22083949
Malik AN, Tariq H, Afridi A, Rathore FA. Technological advancements in stroke rehabilitation. J Pak Med Assoc. 2022;72(8):1672-1674. Doi: https://doi.org/10.47391/JPMA.22-90
Farias DL, Teixeira TG, Tibana RA, Balsamo S, Prestes J. A força de preensão manual é preditora do desempenho da força muscular de membros superiores e inferiores em mulheres sedentárias. Motricidade. 2011;8(S2):624-9.
Villain C, Lebaube S, Kremer C, Chavoix C, Fournel F, Briant AR, et al. Gripwise Versus Jamar: The Challenge of a New Dynamometer Assessing Handgrip Strength. J Gerontol A Biol Sci Med Sci. 2023;78(12):2458-2465. Doi: https://doi.org/10.1093/gerona/glad198
Liu G, Xue Y, Wang S, Zhang Y, Geng Q. Association between hand grip strength and stroke in China: a prospective cohort study. Aging (Albany NY). 2021;13(6):8204-8213. Doi: https://doi.org/10.18632/aging.202630
Bobos P, Nazari G, Lu Z, MacDermid JC. Measurement Properties of the Hand Grip Strength Assessment: A Systematic Review With Meta-analysis. Arch Phys Med Rehabil. 2020;101(3):553-565. Doi: https://doi.org/10.1016/j.apmr.2019.10.183
Leong DP, Teo KK, Rangarajan S, Lopez-Jaramillo P, Avezum A Jr, Orlandini A, et al. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet. 2015;386(9990):266-73. Doi: https://doi.org/10.1016/S0140-6736(14)62000-6
Li G, Lu Y, Shao L, Wu L, Qiao Y, Ding Y, et al. Handgrip strength is associated with risks of new-onset stroke and heart disease: results from 3 prospective cohorts. BMC Geriatr. 2023;23(1):268. Doi: https://doi.org/10.1186/s12877-023-03953-8
Kim Y, Hwang S, Sharp SJ, Luo S, Au Yeung SL, Teerlink CC. Genetic Risk, Muscle Strength, and Incident Stroke: Findings From the UK Biobank Study. Mayo Clin Proc. 2021;96(7):1746-1757. Doi: https://doi.org/10.1016/j.mayocp.2021.01.034
Choi YA. Handgrip Strength and Cognitive Recovery in Older Stroke Survivors: A Prospective Study. Medicina (Kaunas). 2024;60(10):1697. Doi: https://doi.org/10.3390/medicina60101697
Collins K, Johnson N, Klawitter L, Waldera R, Stastny S, Kraemer WJ, et al. Handgrip Strength Asymmetry and Weakness are Differentially Associated with Functional Limitations in Older Americans. Int J Environ Res Public Health. 2020;17(9):3231. Doi: https://doi.org/10.3390/ijerph17093231
Li S, Gonzalez-Buonomo J, Ghuman J, Huang X, Malik A, Yozbatiran N, et al. Aging after stroke: how to define post-stroke sarcopenia and what are its risk factors? Eur J Phys Rehabil Med. 2022;58(5):683-692. Doi: https://doi.org/10.23736/S1973-9087.22.07514-1
Vaishya R, Misra A, Vaish A, Ursino N, D'Ambrosi R. Hand grip strength as a proposed new vital sign of health: a narrative review of evidences. J Health Popul Nutr. 2024;43(1):7. Doi: https://doi.org/10.1186/s41043-024-00500-y
Silva AM, Shen W, Heo M, Gallagher D, Wang Z, Sardinha LB, et al. Ethnicity-related skeletal muscle differences across the lifespan. Am J Hum Biol. 2010;22(1):76-82. Doi: https://doi.org/10.1002/ajhb.20956
Simis M, Imamura M, Sampaio de Melo P, Marduy A, Battistella L, Fregni F. Deficit of Inhibition as a Marker of Neuroplasticity (DEFINE Study) in Rehabilitation: A Longitudinal Cohort Study Protocol. Front Neurol. 2021;12:695406. Doi: https://doi.org/10.3389/fneur.2021.695406
Schmidt RT, Toews JV. Grip strength as measured by the Jamar dynamometer. Arch Phys Med Rehabil. 1970;51(6):321-7.
Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S. Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil. 1985;66(2):69-74.
Compston A. Aids to the investigation of peripheral nerve injuries. Medical Research Council: Nerve Injuries Research Committee. His Majesty's Stationery Office: 1942; pp. 48 (iii) and 74 figures and 7 diagrams; with aids to the examination of the peripheral nervous system. By Michael O'Brien for the Guarantors of Brain. Saunders Elsevier: 2010; pp. [8] 64 and 94 Figures. Brain. 2010;133(10):2838-44. Doi: https://doi.org/10.1093/brain/awq270
Cincura C, Pontes-Neto OM, Neville IS, Mendes HF, Menezes DF, Mariano DC, et al. Validation of the National Institutes of Health Stroke Scale, modified Rankin Scale and Barthel Index in Brazil: the role of cultural adaptation and structured interviewing. Cerebrovasc Dis. 2009;27(2):119-22. Doi: https://doi.org/10.1159/000177918
Maki T, Quagliato E, Cacho E, Paz L, Nascimento N, Inoue M, et al. Estudo de confiabilidade da aplicação da escala de Fugl-Meyer no Brasil. Braz J Phys Ther. 2006;10(2):177-83. Doi: https://doi.org/10.1590/S1413-35552006000200007
Riberto M, Miyazaki MH, Jucá SSH, Sakamoto H, Pinto PPN, Battistella LR. Validação da Versão Brasileira da Medida de Independência Funcional. Acta Fisiátr. 2004;11(2):72-6. Doi: https://doi.org/10.5935/0104-7795.20040003
Anjos LA. Índice de massa corporal (massa corporal estatura-2) como indicador do estado nutricional de adultos: revisão da literatura. Rev Saúde Pública. 1992;26(6):431-6. Doi: https://doi.org/10.1590/S0034-89101992000600009
Bertrand AM, Fournier K, Wick Brasey MG, Kaiser ML, Frischknecht R, Diserens K. Reliability of maximal grip strength measurements and grip strength recovery following a stroke. J Hand Ther. 2015;28(4):356-62. Doi: https://doi.org/10.1016/j.jht.2015.04.004
Park JG, Lee KW, Kim SB, Lee JH, Kim YH. Effect of Decreased Skeletal Muscle Index and Hand Grip Strength on Functional Recovery in Subacute Ambulatory Stroke Patients. Ann Rehabil Med. 2019;43(5):535-543. Doi: https://doi.org/10.5535/arm.2019.43.5.535
Zhang F, Luo B, Bai Y, Zhang Y, Huang L, Lu W. Association of handgrip strength and risk of cardiovascular disease: a population-based cohort study. Aging Clin Exp Res. 2024;36(1):207. Doi: https://doi.org/10.1007/s40520-024-02856-x
Quan S, Jeong JY, Kim DH. The Relationship between Smoking, Socioeconomic Status and Grip Strength among Community-dwelling Elderly Men in Korea: Hallym Aging Study. Epidemiol Health. 2013;35:e2013001. Doi: https://doi.org/10.4178/epih/e2013001
Shaw BA, Spokane LS. Examining the association between education level and physical activity changes during early old age. J Aging Health. 2008;20(7):767-87. Doi: https://doi.org/10.1177/0898264308321081
Arokiasamy P, Selvamani Y, Jotheeswaran AT, Sadana R. Socioeconomic differences in handgrip strength and its association with measures of intrinsic capacity among older adults in six middle-income countries. Sci Rep. 2021;11(1):19494. Doi: https://doi.org/10.1038/s41598-021-99047-9
Lam BC, Koh GC, Chen C, Wong MT, Fallows SJ. Comparison of Body Mass Index (BMI), Body Adiposity Index (BAI), Waist Circumference (WC), Waist-To-Hip Ratio (WHR) and Waist-To-Height Ratio (WHtR) as predictors of cardiovascular disease risk factors in an adult population in Singapore. PLoS One. 2015;10(4):e0122985. Doi: https://doi.org/10.1371/journal.pone.0122985
Amaral CA. Força de preensão manual como biomarcador de saúde de adultos e idosos em Rio Branco, Acre [dissertação]. Rio Branco (AC): Universidade Federal do Acre; 2018.
Huang X, Ma J, Ying Y, Liu K, Jing C, Hao G. The handgrip strength and risk of depressive symptoms: a meta-analysis of prospective cohort studies. Qual Life Res. 2021;30(9):2467-2474. Doi: https://doi.org/10.1007/s11136-021-02858-6
Lang CE, Edwards DF, Birkenmeier RL, Dromerick AW. Estimating minimal clinically important differences of upper-extremity measures early after stroke. Arch Phys Med Rehabil. 2008;89(9):1693-700. Doi: https://doi.org/10.1016/j.apmr.2008.02.022
Bohannon RW. Measurement of trunk muscle strength after stroke: An integrative review. Top Stroke Rehabil. 2022;29(3):173-180. Doi: https://doi.org/10.1080/10749357.2021.1904583
Fujiwara T, Sonoda S, Okajima Y, Chino N. The relationships between trunk function and the findings of transcranial magnetic stimulation among patients with stroke. J Rehabil Med. 2001;33(6):249-55. Doi: https://doi.org/10.1080/165019701753236428
Dromerick AW, Geed S, Barth J, Brady K, Giannetti ML, Mitchell A, et al. Critical Period After Stroke Study (CPASS): A phase II clinical trial testing an optimal time for motor recovery after stroke in humans. Proc Natl Acad Sci U S A. 2021;118(39):e2026676118. Doi: https://doi.org/10.1073/pnas.2026676118
Zasadzka E, Trzmiel T, Kasior I, Hojan K. Does Hand Grip Strength (HGS) Predict Functional Independence Differently in Patients Post Hip Replacement Due to Osteoarthritis versus Patients Status Post Hip Replacement Due to a Fracture? Clin Interv Aging. 2023;18:1145-1154. Doi: https://doi.org/10.2147/CIA.S415744
Matsushita T, Nishioka S, Yamanouchi A, Okazaki Y, Oishi K, Nakashima R, et al. Predictive ability of hand-grip strength and muscle mass on functional prognosis in patients rehabilitating from stroke. Nutrition. 2022;102:111724. Doi: https://doi.org/10.1016/j.nut.2022.111724
Núñez-Cortés R, Cruz BDP, Gallardo-Gómez D, Calatayud J, Cruz-Montecinos C, López-Gil JF, et al. Handgrip strength measurement protocols for all-cause and cause-specific mortality outcomes in more than 3 million participants: A systematic review and meta-regression analysis. Clin Nutr. 2022;41(11):2473-2489. Doi: https://doi.org/10.1016/j.clnu.2022.09.006
Downloads
Publicado
Edição
Seção
Licença
Direitos autorais (c) 2026 Acta Fisiátrica
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
O conteúdo do periódico está licenciado sob uma Licença Creative Commons BY-NC-SA. Esta licença permite que outros remixem, adaptem e criem a partir do seu trabalho para fins não comerciais, desde que atribuam ao autor o devido crédito e que licenciem as novas criações sob termos idênticos.
