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You likely know the importance of increasing client’s overall strength to maintain health, independence, and prevent adverse fall-related events.
But do you know that specifically strengthening your client’s grip is necessary as well?
Read this article to find out why and how to target grip strength.
While grip strength is typically associated with having a strong handshake (which we don't seem to need following the introduction of the elbow bump during 2020), science has shown grip strength to be what's called a biomarker.1
By definition, a biomarker is a broad term which indicates an "objective indication of (a) medical state, observed outside of the patient."2 Basically, it's an indicator of some health condition or state of one's health that isn't necessarily something the patient is aware of.
For example, when one goes to the doctor, they typically explain their symptoms. The symptoms are what a patient is feeling and aware of.
When the doctor does lab work, the doctor may discover some biomarkers, in the form of a high white blood cell count, for example, which indicates a certain illness. The biomarker is the indicator that something is going on or expected to occur.
According to research, grip strength has been found to be a biomarker for "overall strength, upper limb function, bone mineral density, fractures, falls, malnutrition, cognitive impairment, depression, sleep problems, diabetes, multi-morbidity, and quality of life."1
This means that having decreased grip strength has been linked to the following:
Whoa! Right? Who knew grip strength was that important?
After reading all the indicators of poor grip strength you may scare your older adult clients if they tell them that they don't have a strong grip and therefore, may break a hip any second.
Take a deep breath. That is not the case.
Research has simply shown links between grip strength and the above health concerns, but that doesn't mean decreased grip strength will cause a fall or fracture.
However, it is an important indicator to be aware of and to address.
(Proper arm position for handheld dynamometer)
Typically, when your clients go see their primary care doctor, the doc will do quick muscle tests, like have the client grab the doc’s index and middle fingers and squeeze them as hard as they can.
This will give a general idea of decreased grip strength, but it's not the most objective way to measure it.
To be more objective, you can use a device called a handheld dynamometer.
You will have your client place their arm down by their side and then have them bend their elbow to 90 degrees.
Instruct your client to squeeze this device n as hard as they can and hold that squeeze for about five seconds.
The dynamometer will show the grip strength in kilograms.
Have your client repeat the test two more times and then take the average value of the three trials.
Based on research, cutoff scores for older adults to be able to manage heavy tasks are 18.25 kg for females and 28.5 kg for males.
Even if you don’t have the tools to objectively test your clients, you can use the squeeze test. Also, as we know with older adults, strength decreases naturally with age, so it never hurts to bump up the focus on grip strength!
But, in particular, if your client falls below the normative values, it's really important to boost that strength to help increase strength, function, and possibly quality of life!
Using the Lebert Fitness Equalizers is a GREAT way to increase grip strength!
Having your older clients do pull ups with them requires a lot of grip and will improve their grip strength over time.
If your older client can’t perform full pull ups yet, have you tried to modify them?
For example, you can place a fitness step on top of the legs of the Equalizer to limit the range, which may make the exercise achievable for some of your clients.
Or you can use the Equalizers to do standing dips, pushups, or even just have your clients stand and lift the Equalizers off of the ground to promote increased grip strength.
If your client needs some more simplified exercises, check out my recommendations below!
Wring the Towel Horizontal
Wring the Towel Vertically
Rubber Band Extensions
Reverse Wrist Curls
By Dr. Katie Landier, PT, DPT
Board Certified Specialist in Geriatric Physical Therapy