Assessing client’s pinch strength should be done in three different positions, tip pinch (thumb and index finger), tripod pinch (thumb, index and middle finger), and key pinch (thumb pad and lateral aspect of index finger).
- Assessing Tip Pinch:
- 1. Have client seated, with shoulder adducted, elbow flexed to 90 degrees, neutral forearm, wrist 0-30 degrees extension and 0-15 degrees of ulnar deviation
- 2. Hold pinch gauge out to client and have them grasp it between their index finger and their thumb, the index finger should be on top
- 3. Tell client to pinch as hard as they can to get a reading on the gauge
- **Watch that client does not place middle finger over index finger to attempt to pinch harder during this grip**
- 4. Repeat test for 3 trials, the average of the 3 trials should be documented as the strength for tip pinch
(Gett & Romaniw, 2021)
Figure 1 is from Pinch gauge instructions, by Baseline Evaluation Instruments, 2008.
- Assessing Tripod Pinch (Palmar Pinch, 3 Jaw Chuck):
- 1. Have client seated, with shoulder adducted, elbow flexed to 90 degrees, neutral forearm, wrist 0-30 degrees extension and 0-15 degrees of ulnar deviation
- 2. Hold pinch gauge out to client and have them grasp it between their index finger, middle finger and their thumb, the index and middle fingers should be on top
- 3. Tell client to pinch as hard as they can to get a reading on the gauge
- 4. Repeat test for 3 trials, the average of the 3 trials should be documented as the strength for tripod pinch
(Gett & Romaniw, 2021)
Figure 2 is from Pinch gauge instructions, by Baseline Evaluation Instruments, 2008.
- Assessing Key Pinch (Lateral Pinch):
- 1. Have client seated, with shoulder adducted, elbow flexed to 90 degrees, neutral forearm, wrist 0-30 degrees extension and 0-15 degrees of ulnar deviation
- 2. Hold pinch gauge out to client and have them grasp it between their thumb pad and the lateral aspect of their index finger, the thumb pad should be on top
- 3. Tell client to pinch as hard as they can to get a reading on the gauge
- 4. Repeat test for 3 trials, the average of the 3 trials should be documented as the strength for key pinch
(Gett & Romaniw, 2021)
Figure 3 is from Pinch gauge instructions, by Baseline Evaluation Instruments, 2008.
References
Baseline Evaluation Instruments. (2008). Norms for adult pinch strength- Key pinch strength performance of all subjects.
Baseline Evaluation Instruments. (2008). Norms for adult pinch strength- Palmer pinch strength performance of all subjects.
Baseline Evaluation Instruments. (2008). Norms for adult pinch strength- Tip pinch strength performance of all subjects.
Gett, M., & Romaniw, A. (2021, November 2). Strength and manual muscle testing [PowerPoint slides]. Brightspace. https://mylearning.chatham.edu/d2l/le/content/21252/Home
Morton, M. (Photographer). (2021). Pinch gauge: Tip pinch [Photograph].
Occupational Therapy Assessments 