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Testing Process
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The ideal patient position for testing is supine with the head of bed from 30-45 degree angle (per bed angle measurement device). If the patient is not in that position, ask the nurse if he/she can be repositioned. The patient must at least be supine. If the HOB cannot be changed, document the angle of the bed on the data form. Demonstrate use of the device for the patient by stating the following: “I want you to hold the handle like this and squeeze as hard as you can”. The Research Nurse (RN) demonstrates and then gives the dynamometer to the subject. Remind the patient that it won’t be a normal sensation of squeezing something moveable. Reset the gauge to zero. Assist patient in putting device in hand with gauge facing outward and arm extended resting on the bed. The bottom of the device should rest on the bed. Keep hand close by the device, but not touching, to catch it or protect it if the patient loses control of it. If the patient is unable to hold the device steady, you may use 2 fingers on top of the gauge to support the device. Ask the patient if they are ready, then read the following script to the patient to obtain the first grip reading.
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After the subject is positioned appropriately, say, “Are you ready? Squeeze as hard
as you can”. As the subject begins to squeeze, say, “Harder!…Harder!… Relax”.
Repeat with the same instructions for the second and third trial and on each hand.
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After first test, ask the patient “was that okay?” “was that painful?” If not painful, continue with grip testing. If too painful, stop at this point and reassess/reattempt testing at the next visit. If unable to perform grips due to pain on 3 consecutive days, do not attempt further grip assessments on the patient. Document the grip reading (from the inner circle of numbers in pounds force) Reset gauge to zero. Place grip in opposite hand and repeat testing process. Alternate testing between hands until you have obtained 3 readings from each hand. Reset gauge to zero between each reading. Document all readings and any pertinent comments such as HOB angle, patient comments, concerns.
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