The document discusses grip strength measurement, including its importance for assessment and evaluation in various contexts such as medicolegal and insurance. It outlines different testing levels based on hand size, grip strength dynamics, and influencing factors like gender and age. The conclusion emphasizes the necessity of standardized protocols and continuous evaluation for accurate functional outcomes.

1. Grip strength measurement: Why ? Lynne Pringle Cape Town

2. Grip strength testing: Assessment Progress Evaluation Research Medicolegal/ Insurance/IOD

3. Standards/norms Level 2 Reliability/validity Highest average/1 reading/mean 30% of workforce handheld tools Stronger dominant hand Functional outcome ?

4. Dynamometers

5. Principles 1 or 3 trials Arm and elbow position Instructions to patient Malingering/exaggeration Bell curve

6. Bell curve

7. Influencing factors: Dominance Gender and age Examiner Hand size Occupation Motivation Time of day Temperature Day of week

8. Grip strength  Function Cylindrical grip ADL Specific ADL Sustained Repetitive Diagnosis Adaptations Leisure and hobbies

9. Muscles and joints:

11. Grip strength Maximum muscle contraction - shortened Maximum joint flexion

12. Level I: 3.2cm diameter Often excluded Large hands Arthritis Less power

13. Large hand Small hand MCP 90 °, PIP 80°, DIP 85° MCP 80°, PIP 90°, DIP 90°

15. Toothbrush Kettle Steering wheel Screwdriver Lawnmower Spanner Knife Corkscrew Paintbrush Paint roller

16. Hammer Spoon Baton Cup Walking stick saw mug

17. Level 2: 5cm diameter Ideal setting

18. Large hand Small hand MCP 90 °, PIP 70°, DIP 90° MCP 60°, PIP 60°, DIP 90°

19. Small pliers Telephone Scissors Remote control

20. Wood sander Cricket bat Supermarket trolley Tennis racket

21. Level 3: 6.2cm Reading most often used

22. Large hand Small hand MCP 55 °, PIP 70°, DIP 80° MCP 40°, PIP 70°, DIP 90 °

23. Bottles Wood Beverage cans Power tools Pliers scissors

24. Level 4: 7.5cm Heavier items Bilateral

25. Large hand Small hand MCP45 °, PIP 75°, DIP 80° MCP 20°, PIP 80°, DIP 80°

26. Pliers Shears Bottles Pc components Squeeze bottles Tins Staple gun

27. Level 5: 9cm Largest setting Lowest reading often excluded Hand size major factor

28. Large hand Small hand MCP 30 °, PIP 60°, Dip 90° MCP -20°, PIP 80°, DIP 90°

29. Conclusion: Norms  guideline Calibrated dynamometer Curve mandatory Setting 2 Mean

30. Highest result Functional value Functional outcome Continuous evaluation Work hardening progress Baseline

31. Thank you