Experiences of occupational therapy clinicians on the assessment and evaluation of adult handgrip strength

Abstract

Introduction: Handgrip strength (HGS) is commonly measured to assess hand function, however, little is known about how and why occupational therapists assess and interpret HGS. This study aimed to explore the experiences of occupational therapists who work with HGS. Additionally, the study explored what biological and functional factors occupational therapists believe influence adult HGS. Method: A qualitative study design utilising purposive sampling identified occupational therapy clinicians within Queensland, Australia who assess HGS. Data were collected from 19 participants using a semi-structured interview process. The interviews were transcribed verbatim and analysed using thematic analysis. Results: Variations of the American Society of Hand Therapists HGS testing procedure were used by the participants based on experience. When evaluating HGS, comparison to normative data was not always completed or seen to be valuable. Biological and functional factors such as height, hand length, occupation and lifestyle factors were considered to influence HGS. Conclusion: The results of this study provide insight into the various ways occupational therapists assess and evaluate HGS according to experience and practice context. These variations in assessment and evaluation of HGS along with the influence of an individual’s biological and functional factors need to be considered when interpreting HGS results.

The how and why of handgrip strength assessment

“…Choice of lifestyle activities outside of employment was seen to influence HGS. This was supported by Myles et al (2022) who found HGS was influenced by hobbies, sport or unpaid work which requires increased physical demands. As hand function is required to perform most daily activities whether employment-related or during leisure time it is important to consider the influence on HGS of how an individual spends their time and the demands of the activities they are engaged with.…”

“…Ethical approval (number) was granted by (anonymous) in August 2022. This research built on a previous study examining the experiences of occupational therapists within Queensland, Australia to include both occupational therapists and physiotherapists Australia-wide with the hope of allowing for improved transferability of the findings to clinicians who evaluate HGS more broadly (Myles et al, 2022).…”

“…However, all respondents are members of the AHTA and likely to work in professional roles which are primarily focused on assessment and the treatment of the upper limb. Previous research found that clinicians working in hospital and private hand therapy practice settings were less likely to utilise normative data to evaluate HGS scores and more accustomed to comparing with an individual's previous HGS scores or comparing affected versus unaffected upper limbs (Myles et al, 2022). Only 49% of respondents use normative data to evaluate HGS scores with the most commonly referred normative data set being that of Mathiowetz et al (1985).…”

“…This speaks to the concept that interpreting and evaluating HGS goes beyond comparison to normative data and can include comparative evaluation, numerical analysis and feedback from clients based on their goals. Professional experience, practice context and clinical reasoning may be used to inform not only the HGS testing protocol but also the interpretation of the scores on a case-by-case scenario (Myles et al, 2022).…”

“…Few studies have examined how and why clinicians assess and evaluate HGS. This study expanded on previous qualitative research to include physiotherapists along with occupational therapists working within Australia (Myles et al, 2022). The aim of this study was to explore how and why occupational therapists and physiotherapists assess and evaluate HGS.…”