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

In clinical practice, besides dynamometers, the following methods can assist in assessment: 1. Instruct the patient to firmly grip two fingers of the examiner. Based on the pressure felt and whether the examiner can easily withdraw their fingers, the grip strength is classified into four levels: normal, mildly weakened, moderately weakened, and severely weakened. This method can provide a quick judgment when equipment is not available. 2. Have the patient hold objects of different weights (such as paper cups, mineral water bottles, books) in turn, and observe whether they can lift them steadily and resist light pulling. This can provide functional grip strength evidence. 3. Inflate the cuff to 20–30 mmHg, instruct the patient to firmly squeeze, and observe the rise of the mercury column or pointer. This can provide a reference value for repeated measurements. 4. Have the patient firmly grip the fingers of the examiner and record the number of seconds they can maintain maximum force. Patients with weakened muscle strength usually fatigue quickly. The quality of completing daily activities such as screwing bottle caps, carrying water jugs, writing, and buttoning is a true reflection of grip strength function.
These methods are of practical value for outpatient or bedside assessments where a dynamometer cannot be used. However, it is best to use a portable handgrip dynamometer (such as Jamar) for quantitative recording.

Examine grip as a functional test of motor pathways, Neuromuscular Junction, and muscle.
Interpret findings in light of Pharamcology:
Fatigable weakness'n think NMJ disorder (Acetylcholine physiology, cholinestrase inhbitors).
Symmetric, gradual weakness'n think drug-induced myopathy
Acute flaccid weakness 'n think neuromuscular blockers, toxins, or peripheral nerve pathology

 

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.