Abstract
Measurement of grip strength using a handheld dynamometer is frequently performed as part of an orthopedic upper extremity examination. We review the technique of grip strength measurement and evaluation of the possible submaximal effort. What constitutes normal grip strength in one part of the world is not necessarily normal elsewhere. Additionally, there is considerable evidence, most of which is outside the orthopedic literature, that diminished grip strength is a proxy for poor health and a predictor of increased mortality.
Highlights
Measurement of grip strength is commonly performed as part of a hand examination, typically with a handheld hydraulic dynamometer
The device described by Bechtol is given the name Jamar dynamometer and has been called the “gold standard” against which all other dynamometers are measured, as well as the most widely cited in the literature [2 4]
From the above studies, when using the Jamar dynamometer, one maximum grasp at setting 2 with the elbow flexed at 90 degrees can provide a reliable measure of grip strength
Summary
From the above studies, when using the Jamar dynamometer, one maximum grasp at setting 2 with the elbow flexed at 90 degrees can provide a reliable measure of grip strength. Using the Jamar dynamometer, it has been observed that grip strength measurements obtained at all 5 handle positions produced a bell-shaped curve, with maximum grip strength at the second or third handle set, and lower strength with a handle set wide and narrow [17, 19]. The AMA Guides to the Evaluation of Permanent Impairment, 5th Edition, recommends both the rapid exchange grip technique and the 5 handle setting technique to help detect less than maximal effort [9].
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