Purpose
This study evaluated the maximum grip strength in a position of elbow extension versus
flexion as a diagnostic tool in the assessment of a patient with suspected lateral
epicondylitis (LE).
Methods
From our database we identified 81 patients with grip strength measurements and the
diagnosis of LE. From these patient records we collected grip strength measurements
with the elbow in full extension and with the elbow in 90° of flexion for the affected
and the healthy extremity. We then compared 2 values: the pretreatment grip strength
in flexion and extension for the affected extremity and the pretreatment grip strengths
of the nonaffected extremity compared with the affected extremity. Grip strengths
were compared with paired and unpaired 2-tailed t tests.
Results
Grip strength was no different in flexion and extension for the healthy extremity
and 29% stronger in flexion than in extension for the affected extremity. The affected
arm averaged 50% of the strength of the healthy arm in extension and 69% of the strength
of the healthy arm in flexion. These differences were statistically significant. An
8% difference in grip strength between flexion and extension was found to be 83% accurate
in distinguishing the affected from the unaffected extremities.
Conclusions
The measurement of extension grip strength is a useful objective tool to aid in the
diagnosis of LE. In patients with LE, the grip strength decreases as one moves from
a position of flexion to a position of extension.
Type of study/level of evidence
Diagnostic III.
Key words
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Article info
Publication history
Accepted:
March 17,
2007
Received:
March 16,
2007
Footnotes
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Support was received from the Orthopaedic Research Education Foundation and the NIH/NIAMS (AR49407).
Identification
Copyright
© 2007 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
