Grip Strength Test

What is a Grip Strength Test?

Grip strength is a measure of muscular strength or the maximum force/tension generated by your forearm muscles. It estimates hand and forearm strength by measuring the force exerted when squeezing a device, thereby evaluating overall muscle strength.

Hand strength test can be used as a screening tool for measuring upper body strength and overall strength. It is also a beneficial indicator for health outcomes throughout your body. It is most useful when multiple measurements are taken over time to track performance.

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Why is the Grip Strength Test done?

Your doctor will recommend the grip strength test due to the following reasons:

• Detailed Health Assessment: To increase the understanding of your overall health by giving additional insight into musculoskeletal health.
• Detection of diseases: To assist healthcare providers in identifying health conditions, since decreased grip strength is associated with various chronic conditions.‍
• Pre-surgery assessment: Hand surgeons evaluate how well your hand is functioning after any trauma or before and after a hand surgery. The measurement also helps to understand hand strength and gives a picture of recovery after surgery.‍
• Disease prevention: To facilitate detection of risks and formulation of prevention strategies.‍
• Repeated Measurements: Continuous tracking over time can be done through repeated or serial measurements. It can be applied throughout the lifespan to support healthy aging or track rehabilitative progress.

What conditions are associated with the Grip Strength Test?

The grip strength is associated with various health conditions. This association can be divided into two broad categories: as an indicator of the overall function, and as a predictive measure for future health.

Grip strength: An indicator of the overall function

Muscle strength

Grip strength is a simple and effective way to gauge the overall strength of your body. An optimal muscle strength throughout your body is vital for your mobility, balance, and endurance. Having a strong body enables you to have more outings, be more active and in touch with the outside world.

Sarcopenia is a condition characterised by a loss of muscle mass and replacement with fat tissue. If you notice that you are losing strength in your hands and arms, leading to a weaker grip, then it is occurring throughout your body. 

Additionally, you may experience mobility issues, such as difficulty walking or climbing stairs. You are less likely to move your body to build up your muscle strength. Hence, your muscles continue to weaken, which increases the risk for falls and fractures.

Bone mineral density

Having low grip strength is associated with low bone mineral density, which indicates the strength of your bones. It is an important risk factor for osteoporosis, characterised by thin and fragile bones, which causes hip fractures and fragility fractures. Fragility fractures are fractures that happen from a fall of less than standing height.  ‌

Risk of chronic diseases

The risk of chronic diseases increases with decreased grip strength. A lowered grip strength indicates reduced muscle mass, which makes it more difficult to exercise, leading to a sedentary lifestyle and an increased risk of frailty. The risk of chronic conditions such as obesity, Chronic Obstructive Pulmonary Disease, Diabetes, heart disease, stroke, chronic liver disease is increased.

Immune health

The functioning of your immune system decreases as you age, increasing your susceptibility to infection. This is referred to as immunosenescence. Your body loses part of its ability to generate a response to infections due to the loss of muscle mass that occurs with aging. Decreased grip strength is an indication of a weaker immune system, which can leave you more susceptible to illness. Additionally, the risk of complications, severe symptoms, and hospitalisations increases if you have weaker grip strength.

Mental health

The effects of decreased grip strength can be observed throughout your body, including mental health. Lowered grip strength is a marker of reduced muscle strength across your body, which causes decreased mobility. Furthermore, the outcome of reduced mobility can be loneliness as you start losing touch with the outside world, including both family and friends. The isolation harms your brain and emotional well-being. You develop issues with cognition, including memory problems, confusion, and slower processing. Difficulty in sleeping is another adverse effect when your mood is low.

Longevity

In a way, your grip strength is largely a reflection of your overall health and longevity. It can almost predict your future health and life expectancy. Reduced grip strength is a sign of frailty and is linked with a high risk for serious complications and prolonged hospital stay. In contrast, individuals with a strong grip strength tend to remain active well into their older years. 

Grip Strength: Predictive of future health

The grip strength test is an essential tool for determining your future health. It can determine:

• All-cause and disease-specific mortality
• Limb function
• Bone mineral density and fractures
• Mental health and cognition
• Length of hospital stay

How do you prepare for a Grip Strength Test?

No special preparation is required for the hand strength test.

You can gently massage your hands and arms or do light stretches of fingers and hands. This will prevent any injury and prepare your muscles for the test. Additionally, stay hydrated by drinking enough water to ensure proper circulation of nutrients in your body.

How is a Grip Strength Test done?

The equipment for grip strength consists of a dynamometer. Various types of handheld dynamometers have emerged over time. These devices have diverse operating principles; however, all convert the mechanical force of forearm and hand musculature into a quantifiable form. The design principle of the gadgets determined the accuracy of the results. Nowadays, sophisticated motion sensors and virtual reality techniques are also available for assessing hand grip strength.

Before you begin, it is essential to position your arm correctly for the test, as testing in different positions measures different aspects. For instance, testing in sitting versus standing position can change the measurement. 

Testing while seated assesses the strength of smaller muscle groups of the hand and wrist, with the result indicating upper body strength.  In contrast, testing while standing provides a picture of lower-body and core strength used in balance and force exertion. The results of this testing method are indicative of the overall strength.

The steps for measuring grip strength with a dynamometer are as follows:‌

• Hold your arm with your elbow bent at a 90-degree angle.
• Squeeze the dynamometer as much as possible.
• Do not jerk and apply grip force in a smooth motion.
• Repeat twice for a total of three times.
• Your grip strength is the average of the three readings.

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Interpretation of test results

The normal range of grip strength test varies with age, gender, height and hand. For instance, for females aged 20-50 years, the range of normal right grip strength is 25.800kg-35.100kg. For males aged 20-50 years, the range of normal grip strength is 41.3kg-58.8kg. The pictures illustrate the normal range of grip strength for females and males, with an average height of 162 cm for females and 175 cm for males.

After the grip strength test,  you will have a consultation with your doctor or healthcare provider who ordered the test. They will review your results and provide personalised recommendations tailored to your specific goals, whether you are focused on maintaining your current level or building muscle. You will also receive a report for your records, and your results can be compared to monitor your progress by repeat testing in 3-6 months.

What factors affect your Grip Strength?

The results of a grip strength test are affected by factors including:

• Gender
• Age
• Nutritional status
• Handedness
• Forearm and wrist position
• Hand circumference and forearm width
• Arm support
• Psychological factor

How can you increase your Grip Strength?

Your grip strength is an indicator of your overall body strength. Therefore, it is essential to take care of the entire body while strengthening your hands and forearms. 

Diet

A well-balanced diet helps prevent muscle loss and promotes normal muscle strength. Include enough protein in the diet, along with vitamins such as vitamin E, B vitamins, and vitamin D.

Hydration

Water facilitates the delivery of nutrients to the muscles and supports muscle recovery. Staying hydrated during exercise promotes muscle strength and function.

Exercise

You can incorporate various levels of exercise into your daily routine. Some tips for increasing your grip strength:

• Wash your car manually instead of using the automated car wash.
• Consider pushing a lawnmower to cut your grass instead of a riding lawnmower.
• Use a rake to gather leaves instead of blowing them.
• Shovel your snow instead of using a snowblower.
• Open your garage door manually instead of using an electric garage door opener.
• Carry your groceries to your car instead of driving up and having them loaded.
• Squeeze a squash ball or racquet ball. A tennis ball could be larger and a stress ball could be too squishy.

Some activities that can help improve muscle strength include walking, gardening, using exercise bikes, stretching, dancing, yoga, lifting weights, swimming, and participating in water aerobics.

Additionally, strength training should be incorporated by all, especially if you are over 40. You can strength train using your body weight, resistance tubes, free weights, or weight machines. Here are some considerations for getting the most out of your strength training:

• Warm up your muscles by walking 5 or 10 minutes before you begin.
• Select a weight or resistance level that will make your muscles tired after 12 to 15 repetitions. Repetitions or sets of activity can be done. Increase the weight slowly per your tolerance level.
• Working out to make the muscles fatigued is an important part of strength training. Rest for a full day before you exercise the same muscles again.
• Stop the exercise if you experience pain. Select a lower weight or try again in a few days.
• Work with a trainer if you are unsure about the proper technique to avoid injuries
• Make sure you are breathing as you strength train.

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Sources:

1. Physiopedia-Grip strength.‍

https://www.physio-pedia.com/Grip_Strength‍

2. BBC- Grip strength- the test for your chances of living to 100.

‍https://www.bbc.com/future/article/20250417-grip-strength-the-test-for-your-chances-of-living-to-100

3. Lee SY. Handgrip Strength: An Irreplaceable Indicator of Muscle Function. Ann Rehabil Med. 2021;45(3):167-169. doi:10.5535/arm.21106

4. Manoharan VS, Sundaram SG, Jason JI. Factors affecting hand grip strength and its evaluation: A systemic review. Int J Physiother Res. 2015; 3(6):1288-93. https://www.ijmhr.org/ijpr.3.6/IJPR.2015.193.html.