Quality assurance for the handgrip strength and chair stand tests

Based on EHES Manual, Part B. Fieldwork Procedures, 2nd edition (2016) Available at: http://urn.fi/URN:ISBN:978-952-302-701-5 These slides can be used freely, translated and adapted to national use (e.g. concerning the national QA practices).

Quality assurance of handgrip strength and chair stand measurements Adequate training: theory and practice Understanding the difference between clinical practice and survey fieldwork Competence and commitment to follow protocols carefully Checking the equipment and regular calibration of the devices (handgrip strength) Auditing Adherence to the protocol Evaluation of data during the fieldwork

Training of personnel Theory providing information about Why it is important to measure handgrip strength and carry out chair stand tests Why the measurements need to be standardized What implications differences in the protocol have to survey results Practical training, ideally with several different persons with a wide range of physical capability Supervision and feedback

Checking the equipment and regular calibration Protocols for daily and weekly equipment checks recorded in a log book Calibration of used handgrip strength dynamometer before starting the fieldwork If fieldwork lasts longer than a year or the number of daily measurements is high, re-calibration may be needed in between

Audit visits Regular audit visits and observations to ensure that protocol is followed correctly: evaluate adherence to the standard protocol supervise the flow of the survey ensure that the protocol is followed correctly Support and encourage the field personnel

Additional training If the survey is prolonged or any deviations from the protocol are observed, refresher sessions about conducting the tests should be organized when needed or at three month intervals Katso referenssi

Evaluation of measurement data Data should be checked regularly for Missing data and recorded reasons for that Mean and standard deviation for hand grip strength and chair stand test time Values which are possible but rare Separately for each measurer (nurse) If deviations in data are detected, the reasons for this need to be traced, e.g. if due to measurement protocol and/or equipment

Missing data and reasons for that If handgrip strength or timed chair stand test cannot be measured, a reason for that should be recorded It is important to notice that the single chair stand test should be conducted to all participants and the exclusion criteria concerns the repeated (timed) chair stand test Frequency of reasons for exclusion by measurer E.g. if some measurer has a lot of missing information and refusals for the measurement, this may reveal that she/he is not properly introducing the measurement for the participants or not following the protocol properly

Acknowledgements Slides prepared by: Heini Wennman, Päivi Sainio, Päivikki Koponen, Hanna Tolonen Photographs: Hanna Tolonen Demonstrations by voluntary participants Experiences and feedback from the EHES network have been utilized in the preparation of these slides Funding: Preparation of the slides is part of the activities of the EHES Coordinating Centre which has received funding from the EC/DG SANTÉ in 2009-2012 through SANCO/2008/C2/02-SI2.538318 EHES and Grand Agreement number 2009-23-01, and in 2015-2017 through Grand Agreement number 664691/BRIDGE Health

Disclaimer The views expressed here are those of the authors and they do not represent the Commission’s official position.