Grip Strength

Original Editor - Lucinda hampton Top Contributors - Lucinda hampton, Uchechukwu Chukwuemeka and Kim Jackson

Objective

Grip .jpg

Grip strength is a measure of muscular strength or the maximum force/tension generated by one’s forearm muscles. It can be used as a screening tool for the measurement of upper body strength and overall strength. It is most useful when multiple measurements are taken over time to track performance.

Research indicates that grip strength in midlife can predict physical disability in senior years and help evaluate a patient’s overall health. All you need is a hand dynamometer and the hand grip strength norm tables

Intended Population

Grip strength can be used in numerous situations to evaluate and track many health related conditions

The Elderly.

Grip strength grows weaker as we age, which eventually begins to affect our day-to-day. Simple things like opening jars, carrying groceries and turning doorknobs are made more or less difficult depending on the strength of the hands.

It is also a reliable indicator of many health conditions associated with ageing

  • a 2018 prospective study found better handgrip strength was associated with cardiac structure and function in a pattern indicative of less cardiac hypertrophy and remodeling. These characteristics are known to be associated with a lower risk of cardiovascular events[1].
  • In older patients with hip fractures, early grip strength evaluation might provide important prognostic information regarding the patient's future functional trajectory.[2]
  • a 2017 scoping review reported the use of handgrip strength as a way to monitor cognitive changes was important and that reduced handgrip strength over time may serve as a predictor of cognitive loss with advancing age[3]. Similarly a 2016 review found that handgrip strength has apedictive validity for the decline in cognition, mobility, functional status and mortality in older community-dwelling populations[4].
  • Elderly Physio.jpg
    Implementation of grip strength measurement in medicine for older people wards as part of routine admission assessment was recommended ( K Ibrahim et al 2018 study[5]) as low grip strength in older inpatients is associated with poor healthcare outcomes including longer length of stay and mortality.  A high percentage of older patients were identified to be at risk of poor healthcare outcomes as a result of low grip strength and would benefit from nutritional and exercise interventions.

In Conditions of the Upper Limb

Method of Use

To assess grip strength, the Jamar dynamometer is recommended by the American Society for Surgery of the Hand and the American Society of Hand Therapists. These are expensive items and many cheap dynamometers are on the market on-line. They are quite is suitable for physical therapy, or in the doctor’s clinic.

  • The client is seated with shoulder adducted, elbow flexed to 90 degrees, and forearm and wrist neutral. The therapist places the dynamometer in the client’s hand while gently supporting the base of the dynamometer, and he/she instructs the client to squeeze as hard as possible. Grip force should be applied smoothly, without rapid jerking motion. Allow the wrist to extend during the grip.
  • Standard grip test: Three trials on the second handle-width setting.
  • Normative data exists for grip and pinch strength testing. In addition compare readings with the client’s opposite extremity.
  • Before performing strength testing check whether there are any healing tissues that can be damaged by this test and use another outcome measure.

References

  1. Beyer SE, Sanghvi MM, Aung N, Hosking A, Cooper JA, Paiva JM, et al. Prospective association between handgrip strength and cardiac structure and function in UK adults. PloS one. 2018;13(3):e0193124.
  2. Savino E, Martini E, Lauretani F, Pioli G, Zagatti AM, Frondini C, et al. Handgrip strength predicts persistent walking recovery after hip fracture surgery. The American journal of medicine. 2013;126(12):1068-75.
  3. Fritz NE, McCarthy CJ, Adamo DE. Handgrip strength as a means of monitoring progression of cognitive decline–a scoping review. Ageing research reviews. 2017;35:112-23.
  4. Rijk JM, Roos PR, Deckx L, van den Akker M, Buntinx F. Prognostic value of handgrip strength in people aged 60 years and older: a systematic review and meta‐analysis. Geriatrics & gerontology international. 2016;16(1):5-20.
  5. Ibrahim K, May CR, Patel HP, Baxter M, Sayer AA, Roberts HC. Implementation of grip strength measurement in medicine for older people wards as part of routine admission assessment: identifying facilitators and barriers using a theory-led intervention. BMC geriatrics. 2018; 18(1):79. doi: 10.1186/s12877-018-0768-5.