- Hand grip strength indicates muscle strength and can be measured with a Jamar hydraulic hand dynamometer.1 The Jamar dynamometer can assess hand strength to the nearest 1 kg.2
- Studies have shown that using the second handle position on the dynamometer is most efficient.3
- Typical grip strength varies from one person to another. It is preferable to measure the strength of the contralateral hand, rather than comparing measurements among patients. Most people have ~20% more strength in their dominant hand.1
- Grip strength below two standard deviations of the mean may be a sign of carpal tunnel syndrome, cubital tunnel syndrome, cervical radiculopathy, wrist osteoarthritis, rheumatoid arthritis (RA), or Kienbock’s disease.
- The patient’s grip strength may be affected by muscle atrophy or recent injuries.4
- Record the patient’s history, including any sports-related injuries. Ask the patient to rate on a scale from 1 to 10, how much pain s/he usually experiences in the affected hand.
- Ask the patient to sit with his/her shoulder adducted and neutrally rotated, elbow flexed at 90°, forearm in neutral position, and wrist with 0–30° dorsiflexion and 0–15° ulnar deviation.
- Adjust the Jamar dynamometer to the second handle position.3
- Ask the patient to grip the dynamometer using cylindrical grasp for 3 successive trials. Measure the grip strength of each trial.1
- Repeat the process for the contralateral hand.
- The rapid exchange grip test is a variation on the grip strength test that can help to evaluate submaximal grip effort. Perform this test while rapidly exchanging from one side to another.1,5
Related Signs and Tests
- Tenderness with palpation
- Range of motion, active
- Range of motion, passive
- Pinch strength
Diagnostic Performance Characteristics
- The Jamar dynamometer facilitates a reliable measure of isometric grip strength in motivated patients.5
- To improve reliability, also use the rapid exchange grip test.