Interobserver agreement of medical research council sum-score and handgrip strength in the intensive care unit

Introduction: Muscle weakness often complicates critical illness and is associated with devastating short- and long-term consequences. For interventional studies, reliable measurements of muscle force in the intensive care unit (ICU) are needed. Methods: To examine interobserver agreement, two observers independently measured Medical Research Council (MRC) sum-score (n = 75) and handgrip strength (n = 46) in a cross-sectional ICU sample. Results: The intraclass correlation coefficient (ICC) for MRC sum-score was 0.95 (0.920.97). The kappa coefficient for identifying significant weakness (MRC sum-score <48, MRC subtotal upper limbs <24) and severe weakness (MRC sum-score <36) was 0.68 +/- 0.09, 0.88 +/- 0.07, and 0.93 +/- 0.07, respectively. The ICC for left and right handgrip strength was 0.97 (0.940.98) and 0.93 (0.860.97), respectively. Conclusions: Interobserver agreement on MRC sum-score and handgrip strength in the ICU was very good. Agreement on severe weakness (MRC sum-score <36) was excellent and supports its use in interventional studies. Agreement on significant weakness (MRC sum-score <48) was good, but even better using the equivalent cut-off in the upper limbs. It remains to be determined whether this may serve as a substitute. Muscle Nerve 45: 1825, 2012