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Grip Strength

Test, Exam and Sign Description

Hand grip strength is an indicator of general muscle strength that is measured using a hand dynamometer. It may reflect the patient’s general health, physical activity, or even aging. Moreover, it may be an effective tool for prediction of upper extremity trauma outcomes, postoperative results, and as an index of nutritional status.

Subjects squeeze the hand and a manometer with maximal isometric effort to maintain this for approximately 3 seconds. The handle of the dynamometer adjust to several positions to account for different handstands. For most patients handle position 2 will give themost accurate grip strength.3

The Jamar hydraulic hand dynamometer metered is one of a number of different branches to measure grip strength. It is a reliable invalid instrument that serves as a reference standard for validation studies.

DESCRIPTION

Have the individual sit with their shoulder adducted and neutrally rotated, elbow flexed at 90º, forearm in neutral position, and wrist between 0º and 30º dorsiflexion and between 0º and 15º ulnar deviation. Set the JAMAR® Hand Dynamometer to the second handle position from the inside. Lightly hold around the readout dial to prevent inadvertent dropping. After the individual is positioned properly, say, “Squeeze as hard as you can...harder!...harder!...relax.” Record the scores of three successive trials for each hand tested. The average score of the three trials can be compared to the normative data on the left, which is in pounds.

Presentation Photos and Related Diagrams
  • Measuring grip strength with Jamar Dynamometer
    Measuring grip strength with Jamar Dynamometer
  • Measuring grip strength with Jamar Dynamometer
    Measuring grip strength with Jamar Dynamometer
Definition of Positive Result

If measurements fall below two standard deviations of the mean (depending on age group, height, weight, etc.) some pathology may be occuring. In addition, the individuals’ ability to use their hand functionally needs to be considered when interpreting a grip strength performance ie. previous trauma, surgeries, etc.

Definition of Negative Result

From a statistical perspective, scores within two standard deviations of the mean are considered within normal limits.

Comments and Pearls
  • Normal grip strength varies from individual to individual.
  • Always compare affected to unaffect extremities before concluding that the strength is normal or abnormal.
  • Reminder the patient's effort is controlled by the patient and not by the examiner.
  • Submaximal grip effort is difficult to assess even with rapid exchange grip strength testing.5
Diagnoses Associated with Tests, Exams and Signs
References
  1. Bot, A., Mulders, M., Fostvedt, S., & Ring, D. (2012). Determinants of Grip Strength in Healthy Subjects Compared to That in Patients Recovering From a Distal Radius Fracture. The Journal of Hand Surgery,37A, 1874-1880.
  2. Klum, M., Wolf, M., Hahn, P., Leclère, F., Bruckner, T., & Unglaub, F. (2012). Normative Data on Wrist Function. The Journal of Hand Surgery,37A, 2050-2060.
  3. Trampisch, U., Franke, J., Jedamzik, N., Hinrichs, T., & Platen, P. (2012). Optimal Jamar Dynamometer Handle Position to Assess Maximal Isometric Hand Grip Strength in Epidemiological Studies. The Journal of Hand Surgery,37A, 2368-2373.
  4. Cha, S., Shin, H., Kim, K., & Park, J. (2014). Comparison of Grip Strength Among 6 Grip Methods. The Journal of Hand Surgery,37A.
  5. Westbrook AP, Tredgett MW, Davis TRC, Oni JA. The rapid exchange grip strength test and the detection. J Hand Surg 2002; 27A: 329–333