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Strength and Motion

Hand strength & motion assessment: grip/pinch strength correlation to function, normative data, and impact of common pathologies.

Overview

Physical outcome measures in orthopaedic research are shifting toward patient-reported outcomes, with range of motion and strength considered less reliable than previously assumed [1]. Functional range of motion remains important for directing surgical indications and rehabilitation protocols, as well as for assessing treatment outcomes [2]. The arthroscopic Latarjet procedure more commonly affects range of motion rather than shoulder and elbow strength [26]. Age likely has a significant effect on postoperative range of motion and strength [6]. Cross-education effects on shoulder rotator muscle strength and function after shoulder stabilization surgery have no effect on functional outcomes [3].

Evidence from a large registry study supports the hypothesis that early active motion (EAM) rehabilitation may not lead to better long-term range of motion than passive motion protocols for flexor tendon repair [9]. Ideally, digits need sensation and freedom of motion to enable patients to use them effectively, and effective surgery restores biomechanical motions for optimum use [12]. An exercise program for carpometacarpal osteoarthritis was developed in accordance with American College of Sports Medicine guidelines to preserve CMC joint range of motion and increase the strength of the stabilizing muscles of the thumb [14].

Functional capacity evaluations should not replace the surgeon's determination of a patient's abilities based on objective physical examination and radiographic findings [11]. The best form of assessing the ability to return to work is based on a competent physician's understanding of residual impairments combined with knowledge of the patient's work requirements [11]. Surface electromyographic signals can be used to identify maximal versus submaximal efforts in people with upper extremity injuries [15]. The availability of visual feedback may impact grip strength scores when using a digital dynamometer, a feature unavailable with the analog Jamar dynamometer and unaccounted for in existing clinical guidelines [19].

Anatomy & Pathophysiology

Biomechanics and Function

Digits require sensation and freedom of motion to enable effective use, and effective surgery restores biomechanical motions for optimum patient use [12]. The dynamics of hand movement provide a basis for subsequent evaluations of movement patterns performed in activities of daily living (ADLs) and instrumental ADLs [21]. Grip-load force adjustments are not completely determined by the mechanics of object motion; nonmechanical factors related to movement performance, such as perceptual factors, may affect the coupling [18]. Lateral grip styles involve more whole-arm, stabilizing movements while dynamic grip styles require fine dexterous movements [40]. The middle finger is the most important contributor to grip strength [41]. The dominant hand is stronger than the nondominant hand, and no difference exists in three hand strength measurements made under the same conditions [38].

Kinematics and Motion Analysis

Kinematic motion analysis has potential to advance the evaluation and management of upper-extremity disorders, but broad application requires validation and standardization of upper-extremity-specific protocols and decreased logistical and cost burdens [36]. Motion analysis systems provide useful data about actual anatomical deficits in injured fingers by recording dynamic changes in joint angles, although the evaluation is time-consuming [22]. Kinematic variability results from the Jebsen-Taylor Hand Function Test can inform selection of tasks for kinematic evaluation and provide expected variability for comparison to patient populations [44]. Further analysis of the dynamics of the cylinder grip is required to fully understand the cylinder grip in healthy individuals [30]. The dynamic interaction of finger joints during cylinder grip shows specific patterns, with DIP joints consistently initiating flexion last and synchronization increasing significantly by the end of motion compared to the beginning [37].

Pathophysiology and Clinical Deficits

A fracture of the distal radius interferes with the biomechanical integrity of the wrist, limiting range of motion and affecting hand muscle strength [20]. Finger strength is statistically significantly reduced following non-surgical treatment of spiral and oblique metacarpal shaft fractures, but its clinical relevance remains unclear [39]. Limited joint mobility of the thumb and index finger may cause temporal changes in precision grip force control, which can lead to reduced manual dexterity [31]. Index finger PIP joint fusion is associated with impairment in the kinematics of precision pinch [42]. Individuals with hand osteoarthritis modulate grip force magnitude and temporal parameters but apply higher grip forces at liftoff and peak, and demonstrate longer latency compared to controls [35].

Assessment and Measurement

Isometric hand tests improve the measurement of intrinsic and extrinsic hand muscle strength [33]. The opposite hand can be used as a reference to analyze a hand's load-distribution pattern [32]. A novel instrument for quantifying hand forces during a jar opening task can be used to better understand hand kinetics and joint protection strategies intended to reduce hand loads [43].

Classification

Outcome Measurement: Physical outcome measures are shifting toward patient-reported outcomes, as range of motion and strength are not as reliable as previously thought [1]. Functional range of motion is important for directing indications for surgery and rehabilitation, and for assessing treatment outcomes [2].

Assessment Tools: A novel finger grip dynamometer system can measure each finger's grip strength simultaneously and record the time course of grip motion to objectively quantify patient symptoms and evaluate hand function [4]. The Multiple Angle Testing Method can assess the strength of various muscle groups following disease or surgery, determine therapy effectiveness, and detect old muscle injuries missed by existing diagnostic methods [5]. Surface electromyography can be used to identify maximal versus submaximal efforts in people with upper extremity injuries [15].

Biomechanical & Clinical Factors: Improved understanding of carpal motion patterns may lead to changes in functional rehabilitation following injury and in surgical management [7]. Accurate diagnosis and management of hand and carpal fractures and dislocations require a thorough physical examination and appropriate imaging to limit joint stiffness while preserving mobility and function [10]. Grip-load force adjustments are not completely determined by the mechanics of object motion; nonmechanical factors, such as perceptual factors related to movement performance, may affect the coupling [18].

Specific Pathologies: Fossa-foveolar mismatch is highest in dysplastic hips and during external rotation [50]. Thumb strength is affected in all types of triphalangeal thumb, although it is apparently sufficient for daily life in the investigated group [53].

Other Considerations: No differences in physical abilities were observed among low back pain subgroups, and further studies are needed to elucidate if different types of low back pain are related to altered biomechanics, physiology, and function [27]. An exercise program for carpometacarpal osteoarthritis based on biomechanical principles aims to preserve CMC joint range of motion and increase the strength of the stabilizing muscles of the thumb [14]. The increase in passive range of motion of a stiff joint is directly proportional to the total end range time (TERT), or the length of time the joint is held at its end range [16].

Clinical Presentation

Patient-Reported vs. Objective Measures: Physical outcome measures such as range of motion and strength are less reliable than patient-reported outcomes [1]. Functional capacity evaluations should not replace the surgeon's determination of a patient's abilities based on objective physical examination and radiographic findings [11]. For individual patients, the calculated Standard Error of Measurements and Smallest Detectable Differences indicate that only relatively large changes in strength can be confidently detected using handheld dynamometry for intrinsic muscle strength [23].

Assessment of Strength and Function: Functional range of motion is important for directing indications for surgery and rehabilitation, and for assessing treatment outcomes [2]. Cross-education effects on shoulder rotator muscle strength and function after shoulder stabilization surgery have no effect on functional outcomes [3]. A novel finger grip dynamometer system that measures each finger's grip strength simultaneously and records the time course of grip motion can quantify patient symptoms easily and objectively, contributing to the evaluation of hand function [4]. The Multiple Angle Testing Method can assess the strength of various muscle groups following disease or surgery, determine the effectiveness of therapy, and detect old muscle injuries that have escaped detection by existing diagnostic methods [5]. Multifinger performance was not predictable from single-finger strengths, and this information may be helpful to clinically identify and isolate muscle pathology [47].

Hand and Wrist Specific Evaluation: Accurate diagnosis and management of hand and carpal fractures and dislocations are predicated on a thorough physical examination and appropriate imaging to limit joint stiffness while preserving mobility and function [10]. Most patients with carpal tunnel syndrome do not appear to have notable weakness of thumb abduction strength [17]. Subjects with stenosing tenosynovitis demonstrate a significant decrease in maximum velocity in slow fist tasks, highlighting the need for comprehensive assessment to ascertain the full extent of functional limitations [45]. Standard manual strength-testing of the intrinsic muscles of the hand was not diagnostically sensitive [34]. A repeatable technique for measuring palmar thumb abduction strength has excellent nonparametric reliability, though large differences between raters and a lack of variability in the sample limit clinical utility [24].

Dynamometry and Rehabilitation: New features in digital dynamometers, unavailable with the analog Jamar dynamometer and unaccounted for in existing clinical guidelines, could potentially influence grip scores [19]. Standardization and device-specific cutoff points for handgrip dynamometry are needed for use as a diagnostic tool in older adults [46]. The test-retest reliability of grip strength measurement in full elbow extension in healthy participants is excellent, demonstrating its potential for use in clinical practice [48]. Improved understanding of carpal motion patterns may lead to changes in functional rehabilitation following injury and in surgical management [7]. Isolated gracilis tendon harvesting is not associated with loss of strength and maintains good functional outcome [8]. The best form of assessing the ability to return to work is based on a competent physician's understanding of residual impairments combined with knowledge of the patient's work requirements [11].

Investigations

Plain radiography: Accurate diagnosis and management of hand and carpal fractures and dislocations require appropriate imaging to limit joint stiffness while preserving mobility and function [10]. A distal radius fracture interferes with wrist biomechanical integrity, limiting range of motion and affecting hand muscle strength [20].

MRI: Anatomic anterolateral ligament (ALL) reconstruction did not reduce anterolateral rotational laxity [61].

Other Considerations: Physical outcome measures such as range of motion and strength are less reliable than patient-reported outcomes [1]. Functional range of motion is important for directing indications for surgery and rehabilitation, and for assessing treatment outcomes [2]. Age is likely to have a significant effect on postoperative range of motion and strength [6]. Improved understanding of carpal motion patterns may lead to changes in functional rehabilitation following injury and in surgical management [7]. Cross-education effects on shoulder rotator muscle strength and function after shoulder stabilization surgery have no effect on functional outcomes [3]. Isolated gracilis tendon harvesting is not associated with loss of strength and maintains good functional outcome [8]. Most patients with carpal tunnel syndrome do not appear to have notable weakness of thumb abduction strength [17]. No differences in physical abilities were observed among low back pain subgroups, and further studies with appropriate diagnostic procedures are needed to elucidate if different types of low back pain are related to altered biomechanics, physiology, and function [27].

Functional capacity evaluations should not replace the surgeon's determination of a patient's abilities based on objective physical examination and radiographic findings [11]. The best form of assessing the ability to return to work is based on a competent physician's understanding of residual impairments combined with knowledge of the patient's work requirements [11].

A novel finger grip dynamometer system that measures each finger's grip strength and records the time course of grip motion can quantify patient symptoms easily and objectively, contributing to the evaluation of hand function [4]. The Multiple Angle Testing Method can assess the strength of various muscle groups following disease or surgery, determine the effectiveness of therapy, and detect old muscle injuries that have escaped detection by existing diagnostic methods [5]. Identification of three movement phases of the hand during lateral and pulp pinches using video motion capture provides new insight to the dynamics of hand movement and a basis for subsequent evaluations of movement patterns performed in activities of daily living (ADLs) and instrumental ADLs [21]. A motion analysis system provides useful data about actual anatomical deficits in injured fingers by recording dynamic changes in joint angles, though the evaluation is time-consuming [22]. For individual patients, the calculated Standard Error of Measurements and Smallest Detectable Differences indicate that only relatively large changes in strength can be confidently detected with handheld dynamometry [23]. A repeatable technique for measuring palmar thumb abduction strength has excellent nonparametric reliability, though large differences between raters and a lack of variability in the sample limit clinical utility and require further study with a larger, more diverse population [24].

Treatment

Non-Operative

Non-operative management options for conditions such as hallux rigidus and osteoarthrosis of the first metatarsophalangeal joint range from conservative measures to various surgical procedures, with selection depending on disease stage and patient factors [58]. For moderate, nonprogressive deformities like coxa vara, surgery is often not required [57]. Preoperative strengthening interventions can enhance strength, though they do not improve balance or functional outcomes at 6 weeks after total knee replacement [52].

Operative

Indications: Surgical management is indicated for progressive, painful, unilateral coxa vara deformity or leg-length discrepancy [57]. Functional range of motion is critical for directing surgical indications and assessing treatment outcomes [2]. Age significantly affects postoperative range of motion and strength [6]. Patients with shoulder impingement in the nondominant arm demonstrate a more global loss of range of motion compared to those with impingement in the dominant arm [62].

Surgical Approach / Technique: Treatment options for hallux rigidus include cheilectomy, arthroplasty, and arthrodesis [58]. The Tsuge cross short technique demonstrates a lower failure rate than the Tsuge normal technique, with both providing sufficient strength for early active motion [63]. Contralateral C7 transfer shows significant improvements in upper limb function, confirming safety and efficacy, with donor site morbidity that is typically mild and transient [51]. Isolated gracilis tendon harvesting is not associated with loss of strength and maintains good functional outcomes [8]. Adelaide flexor tendon repairs result in high patient satisfaction, grip strength, and return to work, despite limitations in study design [56].

Adjuncts / Rehabilitation: Effective surgery restores biomechanical motions, requiring digits to have sensation and freedom of motion for optimum use [12]. An exercise regimen based on biomechanical principles can preserve carpometacarpal joint range of motion and increase the strength of the thumb’s stabilizing muscles [14]. Surface electromyographic signals help identify maximal versus submaximal efforts in upper extremity injuries to guide immobilization and functional decisions [15]. Movement representation techniques increase pain relief, functional performance, and range of motion compared with conventional rehabilitation in post-orthopaedic surgery individuals [49]. Active motion rehabilitation (EAM) may not lead to better long-term range of motion than passive motion protocols following flexor tendon repair [9]. Cross-education effects on shoulder rotator muscle strength and function after shoulder stabilization surgery have no effect on functional outcomes [3].

Outcomes and Assessment: Physical outcome measures such as range of motion and strength are less reliable than patient-reported outcomes [1]. The Multiple Angle Testing Method can assess the strength of various muscle groups following disease or surgery, determine therapy effectiveness, and detect old muscle injuries missed by existing diagnostic methods [5]. Significant improvements in quality of life and functional capabilities can be achieved following femoral osteotomy, although physical recovery requires an extended duration [13]. Improved understanding of carpal motion patterns may lead to changes in functional rehabilitation following injury and in surgical management [7].

Complications

Measurement Reliability: Physical outcome measures, such as range of motion and strength, are less reliable than patient-reported outcomes [1]. Rapid, repeated measurement of grip strength is not a reliable discriminator of true versus faked hand weakness [28]. Age significantly affects postoperative range of motion and strength [6].

Functional Outcomes & Muscle Recovery: Cross-education effects on shoulder rotator muscle strength and function after shoulder stabilization surgery do not affect functional outcomes [3]. Mid-frequency electrical muscle stimulation during immobilization may prevent early deltoid muscle atrophy and promote early strength recovery after arthroscopic rotator cuff repair, but its long-term impact on functional outcomes remains unclear [25]. A repair site gap of more than three millimeters prevents the accrual of strength and stiffness that normally occurs with time [60].

Procedure-Specific Effects: The Latarjet procedure more commonly affects range of motion rather than shoulder and elbow strength [26].

Recovery

Light activity (weeks): Evidence does not provide specific week ranges for light activity, desk work, or driving.

Full activity (months): Evidence does not provide specific month ranges for manual work, sport, or full range of motion/strength return.

Complete recovery / outcome plateau (months): Idiopathic frozen shoulder is a self-limiting condition in which symptoms subside and full shoulder movement returns within a maximum of two years from the onset of symptoms [65, 66]. Significant improvements in quality of life and functional capabilities can be achieved following femoral osteotomy, though physical recovery requires an extended duration [13]. Further studies with long-term follow-up are needed to determine whether the grafted area will maintain structural and functional integrity over time following autologous matrix-induced chondrogenesis for focal cartilage defects in the knee [55].

Rehabilitation protocol: Active motion rehabilitation may not lead to better range of motion long-term than passive motion protocols following flexor tendon repair [9]. The increase in passive range of motion of a stiff joint is directly proportional to the total end range time (TERT) [16]. Mid-frequency electrical muscle stimulation during immobilization may prevent early deltoid muscle atrophy and promote early strength recovery after arthroscopic rotator cuff repair, but its long-term impact on functional outcomes remains unclear [25]. Cross-education effects on shoulder rotator muscle strength and function after shoulder stabilization surgery have no effect on functional outcomes [3].

Functional milestones: Physical outcome measures such as range of motion and strength are less reliable than patient-reported outcomes [1]. Functional range of motion is important for directing indications for surgery and rehabilitation, and for assessing treatment outcomes [2]. Age will most likely have a significant effect on postoperative range of motion and strength [6]. A novel finger grip dynamometer system that measures each finger's grip strength at one time and records the time course of grip motion can quantify a patient's symptoms easily and objectively, contributing to the evaluation of hand function [4]. Normative data for grip strength across the life course has been provided [64]. Rapid, repeated measurement of grip strength is not a reliable discriminator of true and faked hand weakness [28]. Isolated gracilis tendon harvesting is not associated with loss of strength and maintains good functional outcome [8]. Forty-seven (96%) of forty-nine shoulders had a good clinical result after distal release of deltoid muscle contracture [29].

Other Considerations: Evidence does not provide specific data on rehabilitation protocol phasing, immobilisation duration, weight-bearing/ROM progression, sling/brace removal timing, or validated PROM trajectories (Constant, ASES, WOMAC) beyond the general reliability notes above.

Key Evidence

  • [Paper] Physical outcome measures are being changed for the use of patient reported outcomes, and range of motion and strength are not as reliable measures as one would think. (10.1016/j.injury.2019.11.017)
  • [L4] The functional range of motion is important for directing indications for surgery and rehabilitation, and assessing outcome of treatment. (10.1177/1753193414533754)
  • [L1] However, it has no effect on functional outcomes. (10.1016/j.jse.2023.10.037)
  • [L4] This new system that measures each finger's grip strength at one time and records the time course of grip motion could quantify a patient's symptoms easily and objectively, which may contribute to the evaluation of hand function. (10.1186/s13018-020-01773-9)
  • [L4] It can assess the strength of various muscle groups following disease or surgery, determine the effectiveness of therapy, and detect old muscle injuries that have escaped detection by existing methods of diagnosis. (10.2106/00004623-196345010-00011)
  • [L4] Age will most likely have a significant effect on postoperative ROM and strength. (10.1016/j.jseint.2022.08.016)
  • [L5] Improved understanding of this motion pattern may lead to changes in functional rehabilitation following injury and in surgical management. (10.5435/00124635-201001000-00007)
  • [L3] Additionally, good functional outcome as well as excellent knee-specific subjective outcome was found. (10.1007/s00167-019-05790-y)
  • [L4] This large registry study supports the hypothesis that EAM rehabilitation may not lead to better range of motion long-term than passive motion protocols. (10.1016/j.jhsa.2024.08.003)
  • [L5] Functional capacity evaluations should not replace the surgeon's determination of a patient's abilities based on objective physical examination and radiographic findings; the best form of assessing the ability to return to work is based on a competent physician's understanding of residual impairments combined with knowledge of the patient's work requirements. (10.1016/j.jhsa.2015.11.008)
  • [L5] Ideally, digits need sensation and freedom of motion to enable patients to use them effectively, and effective surgery restores biomechanical motions so patients have optimum use. (10.1016/j.hcl.2013.08.003)
  • [L3] Significant improvements in quality of life and functional capabilities can be achieved following femoral osteotomy, though physical recovery requires an extended duration. (10.1016/j.arth.2025.06.066)
  • [L4] The exercise regimen was developed in accordance with recommendations of the American College of Sports Medicine guidelines for the development of individualized exercise prescriptions to preserve CMC joint range of motion and increase the strength of the stabilizing muscles of the thumb. (10.1016/j.jht.2012.03.008)
  • [L4] The study aimed to identify the specific amount of motion allowed within four different immobilization devices and the level of function allowed within each device to establish data for evidence-based decisions. (10.1016/j.jht.2009.07.011)
  • [L2] The increase in passive range of motion of a stiff joint is directly proportional to the length of time the joint is held at its end range, or total end range time (TERT). (10.1016/j.jht.2011.12.003)
  • [L3] Most patients with CTS do not appear to have notable weakness of thumb abduction strength. (10.1016/j.jhsa.2007.04.007)
  • [L4] Grip-load force adjustments are not completely determined by the mechanics of object motion; nonmechanical factors related to movement performance, for instance perceptual factors, may affect the coupling. (10.1197/j.jht.2007.06.002)
  • [L3] These findings suggest the need to consider how new features, unavailable with the analog Jamar dynamometer and unaccounted for in existing clinical guidelines, could potentially influence grip scores. (10.1016/j.jht.2011.01.004)
  • [L3] These results supported the initial hypothesis that a fracture of the distal radius interferes with the biomechanical integrity of the wrist, limiting range of motion and affecting hand muscle strength. (10.1177/1758998315574352)
  • [L4] The results provide new insight to the dynamics of hand movement as well as a basis for subsequent evaluations of movement patterns performed in ADLs and instrumental ADLs. (10.1007/s11552-013-9517-6)
  • [L4] The motion analysis system provides useful data about actual anatomical deficits in injured fingers by recording dynamic changes in joint angles, though the evaluation is time-consuming. (10.1054/jhsb.1999.0344)
  • [L3] However, for the results of individual patients, the calculated Standard Error of Measurements and the Smallest Detectable Differences indicate that only relatively large changes in strength can be confidently detected with this technique. (10.1054/jhsb.2000.0415)
  • [L5] The study validates a repeatable technique for measuring palmar thumb abduction strength with excellent nonparametric reliability, though large differences between raters and a lack of variability in the sample limit clinical utility and require further study with a larger, more diverse population. (10.1016/j.jht.2018.09.010)
  • [L3] However, its long-term impact on functional outcomes remains unclear and warrants further investigation. (10.1002/ksa.70303)
  • [L4] The findings of this study suggest that the Latarjet procedure more commonly affects range of motion rather than shoulder and elbow strength. (10.1177/17585732231165227)
  • [L4] No differences were observed among the LBP subgroups, and further studies with appropriate diagnostic procedures are needed to elucidate if different types of LBP are related to altered biomechanics, physiology, and function. (10.3390/life11030226)
  • [L3] Rapid, repeated measurement of grip strength is not a reliable discriminator of true and faked hand weakness. (10.1054/jhsb.2000.0433)
  • [L3] Forty-seven (96 per cent) of the forty-nine shoulders had a good clinical result after distal release of the contracture. (10.2106/00004623-199802000-00010)
  • [L4] However, to fully understand the cylinder grip in healthy individuals, further analysis of the dynamics of the cylinder grip is required. (10.1016/j.jhsa.2009.12.031)
  • [L2] Limited joint mobility of the thumb and index finger may cause temporal changes in precision grip force control, which can lead to reduced manual dexterity. (10.1016/j.jht.2013.05.007)
  • [L4] To analyze a hand's load-distribution pattern, the opposite hand can be used as a reference. (10.1016/j.jhsa.2018.02.016)
  • [L4] The new isometric hand tests improve the measurement of intrinsic and extrinsic hand muscle strength. (10.1177/1753193410363532)
  • [L3] Standard manual strength-testing of the intrinsic muscles of the hand was not diagnostically sensitive. (10.2106/00004623-199703000-00013)
  • [L3] Individuals with hand OA modulate grip force magnitude and temporal parameters but apply higher grip forces at liftoff and peak, and demonstrate longer latency compared to controls. (10.1016/j.jht.2011.06.002)
  • [L5] Kinematic motion analysis has exciting potential to advance the evaluation and management of upper-extremity disorders; however, broad application will require validation and standardization of upper-extremity-specific protocols in addition to decreased logistical and cost burdens. (10.1016/j.jhsa.2022.07.016)
  • [L4] The dynamic interaction of finger joints during cylinder grip shows specific patterns, with DIP joints consistently initiating flexion last and synchronization increasing significantly by the end of motion compared to the beginning. (10.1177/1753193412444399)
  • [L4] Finger strength was statistically significantly reduced, but its clinical relevance remains unclear. (10.1186/s12891-025-08776-9)
  • [L4] Lateral grip styles involve more whole-arm, stabilizing movements while dynamic grip styles require fine dexterous movements. (10.1016/j.jht.2021.03.004)
  • [L4] The middle finger was the most important contributor to grip strength. (10.1016/j.jhsa.2014.06.121)
  • [L1] This study reports impairment in the kinematics of precision pinch associated with index finger PIP joint fusion. (10.1016/j.jhsa.2011.09.010)
  • [L4] Our findings support that we have presented a tool which can be used in future study within this population to better understand the hand kinetics associated with the highly problematic task of jar-opening and joint protection strategies intended to reduce hand loads. (10.1016/j.jht.2021.04.012)
  • [L4] Results can be used to inform selection of tasks for kinematic evaluation and provide expected variability for comparison to patient populations. (10.1016/j.jht.2018.10.002)
  • [L3] Those subjects demonstrate a significant decrease in maximum velocity in slow fist tasks, highlighting the need for comprehensive assessment to ascertain the full extent of functional limitations that can occur in the setting of hand pathology. (10.1177/1558944717729218)
  • [L3] For use as a diagnostic tool, standardization and device-specific cutoff points for handgrip dynamometry are needed. (10.1371/journal.pone.0270132)
  • [L4] Multifinger performance was not predictable from single-finger strengths, and the information derived may be helpful to clinically identify and isolate muscle pathology. (10.1197/j.jht.2008.02.002)
  • [L4] The test-retest reliability of grip strength measurement in full elbow extension in healthy participants is excellent, demonstrating its potential for use in clinical practice. (10.1177/1753193412449804)
  • [L1] Compared with conventional rehabilitation, movement representation techniques increase pain relief, functional performance and range of motion. (10.1186/s12891-025-08496-0)
  • [L2] From all analyzed motions, the highest FFM was found in external rotation in all groups. (10.1016/j.asmr.2025.101288)
  • [L5] Published clinical results have demonstrated significant improvements in upper limb function, confirming the procedure's safety and efficacy, with donor site morbidity that is typically mild and transient. (10.1177/17531934251314640)
  • [L2] A preoperative strengthening intervention, regardless of whether it is complemented with balance training, enhances strength but not balance or functional outcomes at 6 weeks after surgery. (10.1007/s00167-020-06029-x)
  • [L4] Strength of the thumb is affected in all types of triphalangeal thumb, although it is apparently sufficient in daily life for the investigated group. (10.1177/1753193412438195)
  • [L4] However, further studies with long-term follow-up are needed to determine whether the grafted area will maintain structural and functional integrity over time. (10.1007/s00167-010-1042-3)
  • [L4] Patient satisfaction, grip strength, and return to work were high despite limitations such as the lack of preoperative outcome measures and no control group. (10.1177/1753193419889297)
  • [L5] Surgical management is indicated for progressive, painful, unilateral deformity or leg-length discrepancy, while moderate nonprogressive deformity often does not require surgery. (10.5435/00124635-199803000-00003)
  • [L5] Treatment options range from non-operative measures to various surgical procedures including cheilectomy, arthroplasty, and arthrodesis, with selection depending on disease stage and patient factors. (10.2106/00004623-199806000-00015)
  • [L5] A gap at the repair site of more than three millimeters does not increase the prevalence of adhesions or impair the range of motion but does prevent the accrual of strength and stiffness that normally occurs with time. (10.2106/00004623-199907000-00010)
  • [L5] Anatomic ALL reconstruction did not reduce anterolateral rotational laxity. (10.1177/2325967116s00027)
  • [L3] Patients with shoulder impingement in their nondominant arm demonstrated a more global loss of range of motion compared with patients having impingement in their dominant arm. (10.1177/036354650002800501)
  • [L5] The Tsuge cross short technique demonstrated a lower failure rate compared with the Tsuge normal technique; nevertheless, both the Tsuge cross and Tsuge cross short techniques had sufficient strength for early active motion. (10.1177/17531934251403976)
  • [L3] This is the first study to provide normative data for grip strength across the life course. (10.1371/journal.pone.0113637)
  • [L4] In the great majority of patients idiopathic frozen shoulder is a self-limiting condition, in which symptoms subside and full shoulder movement returns within a maximum of two years from the onset of symptoms. (10.2106/00004623-197860040-00030)
  • [L4] In the great majority of patients idiopathic frozen shoulder is a self-limiting condition, in which symptoms subside and full shoulder movement returns within a maximum of two years from the onset of symptoms. (10.2106/00004623-197860040-00029)

See Also

References

[1] Physical outcome measures: The role of strength and range of motion in orthopaedic research. Injury. 2020. DOI: 10.1016/j.injury.2019.11.017

[2] The functional range of motion of the finger joints. Journal of Hand Surgery (European Volume). 2014. DOI: 10.1177/1753193414533754

[3] Cross-education effects on shoulder rotator muscle strength and function after shoulder stabilization surgery: a randomized controlled trial. Journal of Shoulder and Elbow Surgery. 2024. DOI: 10.1016/j.jse.2023.10.037

[4] Assessment of grip-motion characteristics in carpal tunnel syndrome patients using a novel finger grip dynamometer system. Journal of Orthopaedic Surgery and Research. 2020. DOI: 10.1186/s13018-020-01773-9

[5] The Multiple Angle Testing Method for the Evaluation of Muscle Strength. The Journal of Bone & Joint Surgery. 1963. DOI: 10.2106/00004623-196345010-00011

[6] Impact of age on shoulder range of motion and strength. JSES International. 2022. DOI: 10.1016/j.jseint.2022.08.016

[7] The Advantage of Throwing the First Stone: How Understanding the Evolutionary Demands of Homo sapiens Is Helping Us Understand Carpal Motion. Journal of the American Academy of Orthopaedic Surgeons. 2010. DOI: 10.5435/00124635-201001000-00007

[8] Isolated gracilis tendon harvesting is not associated with loss of strength and maintains good functional outcome. Knee Surgery, Sports Traumatology, Arthroscopy. 2019. DOI: 10.1007/s00167-019-05790-y

[9] Range of Motion Following Flexor Tendon Repair: Comparing Active Flexion and Extension With Passive Flexion Using Rubber Bands Followed by Active Extension. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2024.08.003

[10] Chapter 29 Hand/Carpal Fractures and Dislocations. 2021.

[11] Functional Capacity Evaluation in Hand Surgery. The Journal of Hand Surgery. 2016. DOI: 10.1016/j.jhsa.2015.11.008

[12] Biomechanics of the Hand. Hand Clinics. 2013. DOI: 10.1016/j.hcl.2013.08.003

[13] A Five-Year Longitudinal Assessment of Quality of Life and Employment Status in Patients Who Have Osteonecrosis of the Femoral Head Undergoing Femoral Osteotomy: A Multicenter Study. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.06.066

[14] An Exercise Program for Carpometacarpal Osteoarthritis Based on Biomechanical Principles. Journal of Hand Therapy. 2012. DOI: 10.1016/j.jht.2012.03.008

[15] Using the Surface Electromyographic Signal to Identify Maximal versus Submaximal Efforts in People with Upper Extremity Injuries. Journal of Hand Therapy. 2009. DOI: 10.1016/j.jht.2009.07.011

[16] Effect of Total End Range Time on Improving Passive Range of Motion. Journal of Hand Therapy. 2012. DOI: 10.1016/j.jht.2011.12.003

[17] Thumb Abduction Strength Measurement in Carpal Tunnel Syndrome. The Journal of Hand Surgery. 2007. DOI: 10.1016/j.jhsa.2007.04.007

[18] Similar Motion of a Hand-held Object may Trigger Nonsimilar Grip Force Adjustments. Journal of Hand Therapy. 2007. DOI: 10.1197/j.jht.2007.06.002

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[20] Pathomechanics of the wrist following fractures of the distal radius. Hand Therapy. 2015. DOI: 10.1177/1758998315574352

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[43] Reliability and validity of a novel instrument for the quantification of hand forces during a jar opening task. Journal of Hand Therapy. 2022. DOI: 10.1016/j.jht.2021.04.012

[44] Assessing kinematic variability during performance of Jebsen-Taylor Hand Function Test. Journal of Hand Therapy. 2020. DOI: 10.1016/j.jht.2018.10.002

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