Which of the following exercises is typically used to measure maximum strength of the upper extremities during a pushing movement?

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Definition[edit | edit source]

A pinch grip is a form of precision grip whereby an object is pinched in three ways. These 3 standard pinch strength tests (see below) are commonly performed within, but not limited to, Occupational and Physical Therapy settings.

Method[edit | edit source]

Pinch dynamometers, or pinch meters are used to assess strength

With the client seated, elbow flexed to 90 degrees with arm adducted at side, and forearm neutral, proceed as follows:

1. Lateral pinch (key pinch): Place the pinchmeter between the radial side of index finger and thumb, and instruct the client to pinch as hard as possible.
2. Three-point pinch (three jaw chuck pinch): Place the pinchmeter between the pulp of the thumb and pulp of the index and middle fingers. Instruct the client to pinch as hard as possible.
3. Two-point pinch (tip to tip pinch): Place the pinchmeter between the tip of the thumb and tip of the index finger, and instruct the client to pinch as hard as possible.

Repeat each test 3 times and calculate an average. Calibrate equipment at least annually[1]. The 4 minute video below is informative

[2]

Use[edit | edit source]

A Positive sign is seen when there is an inability to pinch tip to tip.

These pinch strength test is a critical tool in the functional capacity evaluations eg in job analysis as well as medical settings. These tests provide key insights about a subject’s overall health and/or ability to perform certain tasks effectively.

• In Workers Compensation Cases - help employers confidently if and when employees are ready to either begin or return to work. Certain professions require extensive use of hands and candidates need to be screened to avoid injury.
• In Functional Capacity Evaluation (FCE) Cases - Pinch force gauges help testers estimate the “sincerity of effort” or the “coefficient of variation”. These help employers determine a candidate’s ability to perform tasks requiring manual dexterity and fine motor skills.
• In “Post Offer” Evaluation Cases - These pinch strength exams help indicate an employee’s predisposition to repetitive motion disorders, like Carpal Tunnel Syndrome for example[1].
• The Pinch grip test is also used to examine the neurological dysfunction of the anterior interosseous nerve branch of the median nerve [3]. This is known as Anterior Interosseous Nerve Syndrome (AINS). AINS can be caused by compression of the nerve between the heads of the pronator teres muscle [4]. The anterior interosseous nerve can also become prone to entrapment in certain individuals with abnormalities such as an atypical head of the flexor pollicis longus muscle [5]

Contraindications[edit | edit source]

Testing is contraindicated before full healing following a fracture, ligament repair, tendon laceration, or tendon transfer of the forearm, wrist, or hand, or as determined by the referring physician.[6]

Precautions: defer testing of pinch strength until resistive exercises or strengthening have been approved by the referring physician[6].

Interpretation of Results[edit | edit source]

A Positive sign is seen when there is an inability to pinch tip to tip.

These pinch strength testi is a critical tool in the functional capacity evaluations eg in job analysis as well as medical settings. These tests provide key insights about a subject’s overall health and/or ability to perform certain tasks effectively.

• In Workers Compensation Cases - help employers confidently if and when employees are ready to either begin or return to work. Certain professions require extensive use of hands and candidates need to be screened to avoid injury.
• In Functional Capacity Evaluation (FCE) Cases - Pinch force gauges help testers estimate the “sincerity of effort” or the “coefficient of variation”. These help employers determine a candidate’s ability to perform tasks requiring manual dexterity and fine motor skills.
• In “Post Offer” Evaluation Cases - These pinch strength exams help indicate an employee’s predisposition to repetitive motion disorders, like Carpal Tunnel Syndrome for example[1].
• The Pinch grip test is used to examine the neurological dysfunction of the anterior interosseous nerve branch of the median nerve [3]. This is known as Anterior Interosseous Nerve Syndrome (AINS). AINS can be caused by compression of the nerve between the heads of the pronator teres muscle [4]. The anterior interosseous nerve can also become prone to entrapment in certain individuals with abnormalities such as an atypical head of the flexor pollicis longus muscle [5]

References[edit | edit source]

1. ↑ 1.0 1.1 1.2 Prohealth Pinch Gauge Norms And Testing Protocols https://www.prohealthcareproducts.com/pinch-gauge-norms-and-testing-protocols/ (last accessed 7.11.2020)
2. ↑ kuhealthprofessionals Pinch test Available from: https://www.youtube.com/watch?v=_UPRomXnw-k (last accessed 7.11.2020)
3. ↑ 3.0 3.1 David J. Magee. Orthopedic Physical Assessment. 6th edition. Elsevier. 2014.
4. ↑ 4.0 4.1 Precision- Pinch Grip. Available from: https://functionalanatomyofthehand.wordpress.com/2016/04/14/precision-pinch-grip-2/ (Accessed, 31 October 2020)
5. ↑ 5.0 5.1 Anterior interosseous nerve syndrome. Available from: https://radiopaedia.org/articles/anterior-interosseous-nerve-syndrome-1 (Accessed, 31 October 2020)
6. ↑ 6.0 6.1 Cooper C. Fundamentals of hand therapy. Mosby; 2014.Available from:https://www.sciencedirect.com/topics/nursing-and-health-professions/pinch-strength (last accessed 8.11.2020)

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