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Special Test

Hand Function Tests

Hand Function Tests demonstrate motor and sensory deficits of the hand in the presence of nerve lesions.

Hand Function Tests include:

  1. Pinch Grip,
  2. Key Grip,
  3. Power Grip,
  4. Chuck Grip,
  5. Grip Strength.

Pinch Grip Test

The patient is asked to pick up a small object between the thumb and the index finger.

Satisfactory performance requires intact sensation. The patient should repeat the test with his or her eyes closed.

Unimpaired function of the lumbricals and interossei muscles is essential for this maneuver. At an advanced stage of carpal tunnel syndrome or arthritis of the saddle joint of the thumb, the ability to pinch is diminished or entirely lost.

The sensitivity ranged from 1.7 to 40%; in contrast, the specificity was high (94 to 100%).

See Also: Flexor Tendon Injury of the Hand
Pinch Grip Test
Pinch Grip Test

Key Grip Test

The patient is asked to hold a key between the thumb and the side of the index finger in the normal manner.

A sensory deficit on the radial aspect of the index finger, such as can occur in a radial nerve lesion, or arthritis of the saddle joint of the thumb render the key grip impossible.

Key Grip Test
Key Grip Test

Power Grip Test

The patient is asked to hold onto a pencil with the thumb and fingers while the examiner attempts to pull the pencil away.

If finger flexion is restricted, the test is repeated using an object with a larger diameter.

In the presence of injuries to the median or ulnar nerve, full finger flexion is not possible and strength is limited, causing a positive power grip test.

Power Grip Test
Power Grip Test

Chuck Grip Test

This precision grip maneuver is evaluated by giving the patient a small ball and having him or her hold on to it tightly.

This maneuver tests the strength of adduction of the thumb and finger flexion, thus evaluating the median and ulnar nerves.

Chuck Grip Test

Grip Strength Test

The examiner pumps a rolled-up blood pressure cuff to 20 mm Hg (26.7 kPa) and then asks the patient to squeeze it as tightly as possible.

Patients with normal hand function should attain a value of 200 mm Hg (about 26.7 kPa) or more. The diffierent strengths of men, women and children must be taken into account.

This test should be performed with each hand for comparative evaluation.

The sensitivity and specificity for this test ranged between 1.7 to 65.7% and 65.2 to 100%, respectively.

Grip Strength Test
Grip Strength Test

References

  1. Mahbub MH, Kurozawa Y, Ishitake T, Kume Y, Miyashita K, Sakakibara H, Sato S, Toibana N, Harada N. A systematic review of diagnostic performance of quantitative tests to assess musculoskeletal disorders in hand-arm vibration syndrome. Ind Health. 2015;53(5):391-7. doi: 10.2486/indhealth.2014-0221. Epub 2015 Jun 6. PMID: 26051288; PMCID: PMC4591131.
  2. Clinical Tests for the Musculoskeletal System 3rd Edition.
  3. Dutton’s Orthopaedic Examination, Evaluation, And Intervention 3rd Edition.
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