A practical posture for hand grip dynamometry in the clinical setting

Summary Background & Aims : The optimal testing position for hand grip strength, which is a useful functional measure of nutritional status, is open to debate. We therefore examined the systematic difference between different postures in order to establish a methodology that is clinically relevant, easy to perform and reproducible. Methods : Grip strength was measured in the dominant and non-dominant hands with a strain gauge dynamometer in three positions: lying at 30° in bed with elbows supported, seated in an armchair with elbows supported and in a chair with elbows unsupported. The average of three readings made in each position, each 1min apart, was recorded. Results : 55 normally nourished subjects (26 male) were studied. Mean (95% CI) grip strengths measured in the dominant hand with the subject in bed, sitting in an armchair and sitting in a chair were 45.7 (42.3–49.2), 46.3 (42.9–49.8) and 48.5 (45.4–51.7)kg, respectively for males. Corresponding values for females were 29.4 (27.0–31.8), 29.3 (26.8–31.9) and 31.6 (28.8–34.3)kg. There was no significant difference (Student t -paired test) between measurements made in bed and on an armchair ( P = 0.49 ), but the measurements made in a chair were significantly higher than those made in bed ( P = 0.001 ) and in an armchair ( P = 0.004 ). No statistical difference was present, comparing the three separate measurements in each position (Student t -paired test). Conclusions : Measurement of grip strength using hand dynamometry is reproducible and consistent. As all patients are not able to sit in a chair with elbows unsupported, in clinical practice it is more practicable to perform hand dynamometry with the elbows supported in a bed or armchair.