How to examine for power of grip in a patient with weakness?

 

Grip strength is usually assessed as part of a neurological or musculoskeletal exam. The simplest and most reliable bedside method is the “handshake” test: 
Positioning – Ask the patient to flex the elbow to 90° with the forearm in neutral position.
Instruction – Tell the patient: “Squeeze my fingers as hard as you can.” Place your two fingers or your whole hand in their palm.
Assessment – Compare the strength between both hands. Note if the squeeze is weak, fatigues quickly, or is absent.
Grading – Use the standard Medical Research Council (MRC) scale (0 = no movement, 5 = normal power). Grip strength corresponds to finger flexors (median and ulnar nerves, C7–T1 roots).
Additional clues – Look for asymmetry, pain limitation, or associated neurological signs (wasting, fasciculations, sensory loss).
Where available, dynamometers (e.g., Jamar hand dynamometer) provide an objective measurement in kilograms or newtons and are often used in rehabilitation or research.  At the bedside, grip power is examined by asking the patient to squeeze your fingers and grading the response on the MRC scale, with comparison to the opposite side. A dynamometer can provide quantitative confirmation.
 

Evaluating grip strength in patients with muscular weakness entails diverse clinical techniques that yield objective data. These techniques are essential for detecting disorders such as chronic inflammatory demyelinating polyneuropathy (CIDP) and assessing surgical healing. Among the measurement options are: The Q-Motor Grip Force Assessment (QGFA) is employed to objectively measure muscular weakness in patients with CIDP. It quantifies grip force and involuntary motions by electromagnetic sensors, yielding metrics such as grip force variability and position index, as referenced in Klehmet et al., 2019. This approach demonstrates significant connections with conventional illness severity ratings, signifying its efficacy in identifying subclinical muscular weakness. Dynamometry has been previously mentioned; nevertheless, low-tech approaches, such as adapted manual sphygmomanometers, can exhibit a strong correlation with formal dynamometry, hence enhancing the accessibility of grip strength testing in diverse clinical environments.

I'd be happy to help you find methods for examining hand grip power beyond dynamometry. To ensure I provide the most relevant information, could you clarify a few things:Are you looking for bedside clinical tests that don't require any equipment at all, or are simple tools (like everyday objects) acceptable?Is this for a specific patient population (e.g., elderly, pediatric, stroke patients, or those with specific neurological conditions)?Are you interested in purely strength assessment, or would functional grip assessments (like ability to perform daily tasks) also be useful?These details will help me find the most appropriate examination techniques for your clinical needs.