title: A practical posture for hand grip dynamometry in the clinical setting.
abstract: OBJECTIVE
  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 degrees 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.
authors.affiliation: Section of Surgery, Queen's Medical Centre, University Hospital, Nottingham NG7 2UH, UK.
authors.forename: T E
authors.initials: TE
authors.lastname: Hillman
authors.forename: Q M
authors.initials: QM
authors.lastname: Nunes
authors.forename: S T
authors.initials: ST
authors.lastname: Hornby
authors.forename: Z
authors.initials: Z
authors.lastname: Stanga
authors.forename: K R
authors.initials: KR
authors.lastname: Neal
authors.forename: B J
authors.initials: BJ
authors.lastname: Rowlands
authors.forename: S P
authors.initials: SP
authors.lastname: Allison
authors.forename: D N
authors.initials: DN
authors.lastname: Lobo
mesh_terms: D000328:Adult; D004550:Elbow / Q000502:physiology; D005260:Female; D006225:Hand / Q000502:physiology; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D007374:Interior Design and Furnishings / Q000592:standards; D008297:Male; D009119:Muscle Contraction / Q000502:physiology; D009752:Nutritional Status; D011187:Posture / Q000502:physiology; D015203:Reproducibility of Results