An exploration of the mechanistic link between the enhanced paper grip test and the risk of falling

TY - JOUR

T1 - An exploration of the mechanistic link between the enhanced paper grip test and the risk of falling

AU - Mansi, Mahmoud K.

AU - Chockalingam, Nachiappan

AU - Chatzistergos, Panagiotis E.

N1 - Publisher Copyright: © 2023 The Authors

PY - 2023/12

Y1 - 2023/12

N2 - The enhanced paper grip test (EPGT) offers an easy-to-use measure of hallux plantar-flexion strength that does not need expensive specialised equipment. Literature suggests that it could be a useful screening tool to assess the risk of falling in older people. However, research on a specific mechanistic link to the risk of falling is lacking. It is hypothesised here that muscle weakening (assessed by the EPGT) is indicative of impaired ability to recover balance after a slip or a trip. To get an initial assessment of validity of the above hypothesis, the EPGT is compared against an established lab-based measure of lower-limb strength that is capable of assessing a person's ability to recover balance after a slip or a trip: maximum isometric leg press push-off force (leg press force). A gender-balanced sample of twenty people (median age=34 y) was recruited. Two different but equaly valid techniques of administering the EPGT were included regarding whether the participants’ ankle was supported by the examiner or not. Results for the two EPGT techniques differed susbtantialy but they were both significantly associated with leg press force and therefore linked to better ability to maintain balance after a slip or a trip. The “ankle not held” EPGT technique was more strongly correlated to leg press force (r(18) = 0.652, p = 0.002) than the “ankle held” (r(18) = 0.623, p = 0.003) and appears to be the more favourable technique to administer the EPGT. These findings offer new insight on a potential mechanistic link between the EPGT and the risk of falling and support its optimal use in future research involving older people.

AB - The enhanced paper grip test (EPGT) offers an easy-to-use measure of hallux plantar-flexion strength that does not need expensive specialised equipment. Literature suggests that it could be a useful screening tool to assess the risk of falling in older people. However, research on a specific mechanistic link to the risk of falling is lacking. It is hypothesised here that muscle weakening (assessed by the EPGT) is indicative of impaired ability to recover balance after a slip or a trip. To get an initial assessment of validity of the above hypothesis, the EPGT is compared against an established lab-based measure of lower-limb strength that is capable of assessing a person's ability to recover balance after a slip or a trip: maximum isometric leg press push-off force (leg press force). A gender-balanced sample of twenty people (median age=34 y) was recruited. Two different but equaly valid techniques of administering the EPGT were included regarding whether the participants’ ankle was supported by the examiner or not. Results for the two EPGT techniques differed susbtantialy but they were both significantly associated with leg press force and therefore linked to better ability to maintain balance after a slip or a trip. The “ankle not held” EPGT technique was more strongly correlated to leg press force (r(18) = 0.652, p = 0.002) than the “ankle held” (r(18) = 0.623, p = 0.003) and appears to be the more favourable technique to administer the EPGT. These findings offer new insight on a potential mechanistic link between the EPGT and the risk of falling and support its optimal use in future research involving older people.

KW - Accidental falls

KW - Lower limb

KW - Muscle strength

KW - Risk assessment

KW - Screening

KW - Toe grip

UR - https://www.scopus.com/pages/publications/85175635648

U2 - 10.1016/j.foot.2023.102059

DO - 10.1016/j.foot.2023.102059

M3 - Article

C2 - 37926054

AN - SCOPUS:85175635648

SN - 0958-2592

VL - 57

JO - Foot

JF - Foot

M1 - 102059

ER -