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Journal of Occupational Rehabilitation

, Volume 24, Issue 2, pp 325–331 | Cite as

Weak Grip Strength Does not Predict Upper Extremity Musculoskeletal Symptoms or Injuries Among New Workers

  • Ann Marie Dale
  • Lesley Addison
  • Josh Lester
  • Vicki Kaskutas
  • Bradley Evanoff
Article

Abstract

Purpose Grip strength is often tested during post-offer pre-placement screening for workers in hand-intensive jobs. The purpose of this study was to evaluate the association between grip strength and upper extremity symptoms, work disability, and upper extremity musculoskeletal disorders (UE MSDs) in a group of workers newly employed in both high and low hand intensive work. Methods 1,107 recently-hired workers completed physical examinations including grip strength measurements. Repeated surveys obtained over 3 years described the presence of upper extremity symptoms, report of physician-diagnosed musculoskeletal disorders (MSDs), and job titles. Baseline measured grip values were used in analytic models as continuous and categorized values to predict upper extremity symptoms, work disability, or UE MSD diagnosis. Results Twenty-six percent of males and 20 % of females had low baseline hand strength compared to normative data. Multivariate logistic regression analyses showed no consistent associations between grip strength and three health outcomes (UE symptoms, work disability, and MSDs) in this young cohort (mean age 30 years). Past MSD and work type were significant predictors of these outcomes. Conclusions Physical hand strength testing was not useful for identifying workers at risk for developing UE MSDs, and may be an inappropriate measure for post-offer job screens.

Keywords

Strength Occupation Prediction modeling Post-offer pre-placement examination 

Notes

Acknowledgments

This study was supported by Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Grant Number R01OH008017-01.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Bureau of Labor Statistics USDoL. Nonfatal occupational injuries and illnesses requiring days away from work, 2011: Bureau of Labor Statistics, United States Department of Labor. 2013.Google Scholar
  2. 2.
    Dunning KK, Davis KG, Cook C, Kotowski SE, Hamrick C, Jewell G, et al. Costs by industry and diagnosis among musculoskeletal claims in a state workers compensation system: 1999–2004. Am J Ind Med. 2010;53(3):276–84.PubMedGoogle Scholar
  3. 3.
    Chaffin DB, Herrin GD, Keyserling WM. Preemployment strength testing: an updated position. J Occup Med. 1978;20(6):403–8.PubMedGoogle Scholar
  4. 4.
    Reneman MF, Soer R, Gerrits EH. Basis for an FCE methodology for patients with work-related upper limb disorders. J Occup Rehabil. 2005;15(3):353–63.PubMedCrossRefGoogle Scholar
  5. 5.
    Rosenblum KE, Shankar A. A study of the effects of isokinetic pre-employment physical capability screening in the reduction of musculoskeletal disorders in a labor intensive work environment. Work Reading Mass. 2006;26(2):215–28.Google Scholar
  6. 6.
    Genovese E, Galper J. Guide to the evaluation of functional ability. Chicago: American Medical Association; 2009.Google Scholar
  7. 7.
    Hart DL, Isernhagen SJ, Matheson LN. Guidelines for functional capacity evaluation of people with medical conditions. J Orthop Sports Phys Ther. 1993;18(6):682–6.PubMedCrossRefGoogle Scholar
  8. 8.
    Isernhagen S. Functional capacity evaluation: rationale, procedure, utility of the Kinesiophysical approach. J Occup Rehabil. 1992;2:157–68.PubMedCrossRefGoogle Scholar
  9. 9.
    Richards L, Palmiter-Thomas P. Grip strength measurement: a critical review of tools, methods and clinical utility. Crit Rev Phys Rehabil Med. 1996;8(1 & 2):87–109.Google Scholar
  10. 10.
    Frederiksen H, Hjelmborg J, Mortensen J, McGue M, Vaupel JW, Christensen K. Age trajectories of grip strength: cross-sectional and longitudinal data among 8,342 Danes aged 46–102. Ann Epidemiol. 2006;16(7):554–62.PubMedCrossRefGoogle Scholar
  11. 11.
    Agnew PJ, Maas F. Hand function related to age and sex. Arch Phys Med Rehabil. 1982;63(6):269–71.PubMedGoogle Scholar
  12. 12.
    Crosby CA, Wehbé MA, Mawr B. Hand strength: normative values. J Hand Surg Am. 1994;19(4):665–70.PubMedCrossRefGoogle Scholar
  13. 13.
    Harth A, Vetter W. Grip and pinch strength among selected adult occupational groups. Occup Ther Int. 1994;1:13–28.CrossRefGoogle Scholar
  14. 14.
    Robertson LD, Mullinax CM, Brodowicz GR, Swafford AR. Muscular fatigue patterning in power grip assessment. J Occup Rehabil. 1996;6(1):71–85.PubMedCrossRefGoogle Scholar
  15. 15.
    Wind AE, Takken T, Helders PJM, Engelbert RHH. Is grip strength a predictor for total muscle strength in healthy children, adolescents, and young adults? Eur J Pediatr. 2010;169(3):281–7.Google Scholar
  16. 16.
    Holtermann A, Blangsted AK, Christensen H, Hansen K, Søgaard K. What characterizes cleaners sustaining good musculoskeletal health after years with physically heavy work? Int Arch Occup Environ Health. 2009;82(8):1015–22.PubMedCrossRefGoogle Scholar
  17. 17.
    Harbin G, Olson J. Post-offer, pre-placement testing in industry. Am J Ind Med. 2005;47(4):296–307.PubMedCrossRefGoogle Scholar
  18. 18.
    Hamberg-van Reenen HH, Ariëns GA, Blatter BM, van Mechelen W, Bongers PM. A systematic review of the relation between physical capacity and future low back and neck/shoulder pain. Pain. 2007;130(1–2):93–107.PubMedCrossRefGoogle Scholar
  19. 19.
    Gardner BT, Dale AM, Vandillen L, Franzblau A, Evanoff BA. Predictors of upper extremity symptoms and functional impairment among workers employed for 6 months in a new job. Am J Ind Med. 2008;51(12):932–40.PubMedCrossRefGoogle Scholar
  20. 20.
    Armstrong T, Dale A, Franzblau A, Evanoff B. Risk factors for carpal tunnel syndrome and median neuropathy in a working population. J Occup Environ Med. 2008;50(12):1355–64.PubMedCrossRefGoogle Scholar
  21. 21.
    Sluiter JK, Rest KM, Frings-Dresen MH. Criteria document for evaluating the work-relatedness of upper-extremity musculoskeletal disorders. Scand J Work Environ Health. 2001;27(Suppl 1):1–102.PubMedCrossRefGoogle Scholar
  22. 22.
    Mathiowetz V, Weber K, Volland G, Kashman N. Reliability and validity of grip and pinch strength evaluations. J Hand Surg Am. 1984;9(2):222–6.PubMedCrossRefGoogle Scholar
  23. 23.
    Fess E. Grip strength. Clinical assessment recommendations. 2nd ed. Chicago: American Society of Hand Therapists; 1992. p. 41–5.Google Scholar
  24. 24.
    Mathiowetz V, Rennells C, Donahoe L. Effect of elbow position on grip and key pinch strength. J Hand Surg Am. 1985;10(5):694–7.PubMedCrossRefGoogle Scholar
  25. 25.
    MacDermid JC, Kramer JF, Woodbury MG, McFarlane RM, Roth JH. Interrater reliability of pinch and grip strength measurements in patients with cumulative trauma disorders. J Hand Ther. 1994;7(1):10–4.PubMedCrossRefGoogle Scholar
  26. 26.
    Hamilton A, Balnave R, Adams R. Grip strength testing reliability. J Hand Ther. 1994;7(3):163–70.PubMedCrossRefGoogle Scholar
  27. 27.
    Niebuhr BR, Marion R, Fike ML. Reliability of grip strength assessment with the computerized Jamar dynamometer. Occup Ther J Res. 1994;14(1):3–18.Google Scholar
  28. 28.
    Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, et al. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am. 1993;75(11):1585–92.PubMedGoogle Scholar
  29. 29.
    Günther CM, Bürger A, Rickert M, Crispin A, Schulz CU. Grip strength in healthy Caucasian adults: reference values. J Hand Surg Am. 2008;33(4):558–65.PubMedCrossRefGoogle Scholar
  30. 30.
    SPSS Base 16.0, 2007. SPSS Inc., Chicago, IL.Google Scholar
  31. 31.
    Savinainen M, Nygård CH, Ilmarinen J. A 16-year follow-up study of physical capacity in relation to perceived workload among ageing employees. Ergonomics. 2004;47(10):1087–102.PubMedCrossRefGoogle Scholar
  32. 32.
    Ryan S. The predictive capacity of declared musculoskeletal disorder at pre-employment screening. Occup Med Oxf. 2010;60(5):354–7.PubMedCrossRefGoogle Scholar
  33. 33.
    Mahmud N, Schonstein E, Schaafsma F, Lehtola MM, Fassier JB, Reneman MF et al. Pre-employment examinations for preventing occupational injury and disease in workers. Cochrane Database Syst Rev. 2010 (12): CD008881.Google Scholar
  34. 34.
    Mohr S, Gochfeld M, Pransky G. Genetically and medically susceptible workers. Occup Med State Art Rev. 1999;14(3):595–611.Google Scholar
  35. 35.
    Pachman J. Evidence base for pre-employment medical screening. Bull World Health Organ. 2009;87(7):529–34.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Ann Marie Dale
    • 1
  • Lesley Addison
    • 2
  • Josh Lester
    • 3
  • Vicki Kaskutas
    • 3
  • Bradley Evanoff
    • 1
  1. 1.Division of General Medical SciencesWashington University School of MedicineSaint LouisUSA
  2. 2.Hand therapy CenterHand Center of LouisianaMetairieUSA
  3. 3.Program in Occupational TherapyWashington University School of MedicineSaint LouisUSA

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