A practical posture for hand grip dynamometry in the clinical setting

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 1 min 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