ABSTRACT

A small number of methods and instruments are used by hand therapists and medical practitioners to assess wrist strength. However, there are characteristics unique to the wrist joint that make the reliability of measuring the strength of muscles acting on the wrist more difficult. Also, it is important to understand the strengths and limitations of the various methods and instruments when using them to measure wrist strength. A clear understanding of factors that contribute (or otherwise) to reliable measurements of wrist strength is desirable for use as indicators of treatment or to determine the benefits of intervention. The aim of this review is to explore the suitability of manual muscle testing and hand-held dynamometry for measuring wrist strength. Reliability of manual muscle testing and hand-held dynamometry is reviewed and then discussed in the light of how the findings relate to the measurement of strength of muscle groups acting on the wrist. The relationship between hand and wrist strength is also explored, because hand strength is often used as a measure of strength outcome following wrist intervention or treatment. The variables and issues that affect the reliability of wrist strength measurement are identified, and on the basis of this, recommendations are made concerning the key characteristics that would need to be considered if a new instrument were to be developed for assessing wrist strength or exploring the relationship between hand and wrist strength. This review is based on a search of the relevant literature. The literature review includes articles published from 1982 to 2000, with some key articles in the period from 1956 to 1982. A range of journals with a focus on rehabilitation and movement and exercise science, as well as surgical journals that include a particular focus on hand and wrist surgery, were included.