Clinical Telemedical Measurement of Grip Strength Thresholds for Work-Related Injury Permanent Impairment Rating

Neuromuscular grip strength evaluation is challenging with the growing importance of telemedicine. Objective documentation of this hand function requires a simple procedure using an expensive dynamometer (e.g., a JAMAR grip dynamometer) traditionally used in an in-person medical office setting. This pilot study tests a method of measuring grip strength via telemedicine to determine if an individual, with a work-related injury, meets American Medical Association Guides criteria for permanent impairment to be eligible for insurance benefits. The procedure involves griping a specified water bottle, commonly found in one’s home, that is elevated and horizontal.  The procedure requires the individual to suddenly squeeze hard to project the water. The height of the water bottle and maximum distance of the water stream are measured.  An individual who does not meet a minimum distance of projection may qualify for compensation due to loss of grip strength. Thirty-nine volunteers in this pilot study provide calibration for this procedure, each doing five repeated trials according to the established protocol.  The many subtle details and results of this pilot study are presented in this paper.