Daily grip strength response to intravenous immunoglobulin in chronic immune neuropathies

Muscle Nerve. 2020 Jul;62(1):103-110. doi: 10.1002/mus.26898. Epub 2020 May 8.

Abstract

Introduction: Monitoring grip strength at home may detect improvement between intravenous immunoglobulin (IVIg) treatments in patients with chronic inflammatory neuropathies (CINs).

Methods: Fifteen patients recorded grip strength each day, from one IVIg treatment until the next. We analyzed grip strength changes comparing thresholds of 8 kPa and 14 kPa. "Random" fluctuations of grip strength were distinguished from treatment response by smoothing the data.

Results: "Random" fluctuations of at least 8 kPa occurred in 27% of patients. Smoothed daily grip strength increased by at least 8 kPa above baseline in 11 (73%) patients. Grip strength increased by at least 8 kPa for 3 consecutive days in 9 (60%) patients, and 5-day block mean increased by at least 8 kPa in 10 (67%) patients.

Discussion: Home monitoring of grip strength confirmed treatment response in most patients with CINs on IVIg. To detect improvement in an individual patient, we suggest a threshold of at least 8 kPa on 3 consecutive days or on 5-day block mean.

Keywords: CIDP; chronic inflammatory demyelinating polyneuropathy; grip strength; multifocal motor neuropathy; outcome measures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Female
  • Hand Strength / physiology*
  • Home Care Services / standards
  • Home Care Services / trends*
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage*
  • Male
  • Middle Aged
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / diagnosis*
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / drug therapy*
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / physiopathology
  • Self Report / standards

Substances

  • Immunoglobulins, Intravenous