Grip strength testing is an objective measure that is highly utilized among clinicians. Grip strength testing can tell us a lot about an individual. However, when we proceed to test these individuals, the question becomes, how should we test them?
Literature has indicated it is important to have a standardized protocol to determine reliable and valid measurements.1 The individual should be seated with their arm adducted to 0° and elbow flexed to 90° while using the second handle position of the dynamometer.1
However, should this be the case? Should we test individuals based on recommendations, or should we think about testing positions that are meaningful to the patient?
Let’s think of a scenario. The patient is an electrician who has difficulty when using a screwdriver with his arm in overhead positions. The dysfunction is located when their arm is reached overhead when performing various occupational tasks. However, testing guidelines tell us we need to test the individual with their arm at their side, with the elbow at 90° of flexion.
Does this accurately capture the functional limitations? Is this meaningful to the patient?
Perhaps we should make testing more individualized and specific to the patient’s current impairments and functional limitations. Why can’t we test in alternative positions? Let’s take a look.
Studies have demonstrated that there were no differences noticed with varying arm positions between right- and left-hand grip strength.2 Literature has also investigated on self-selected hand position during the grip strength assessment.3 The study wanted to examine if subjects were able to self-select handgrip positions on the device in which maximal handgrip strength could be delivered.3
Maybe its time we reexamine different ways of evaluating our patients. We need to ensure we able to really grasp what the patient is experiencing, but more so how do we guide them during care.
Next time you perform grip strength testing, make sure it is purposeful and meaningful to the individual.
Article Written By Eric Trauber, PT, DPT, OCS, CSCS, FAAOMPT
References:
- Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, & Rogers Sandra. (1985). Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil, 66:69-74.
- El-gohary TM, Elkader SMA, Al-shenqiti AM, & Ibrahim MI. (2019). Journal of Taibah University Medical Sciences, 14(6): 566-571.
- Boadella JM, Kuijer PP, Sluiter JK, and Frings-Dresen MH. Effect of self-selected handgrip position on maximal handgrip strength. Arch Phys Med Rehabil, 2005, 86:328-331.