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Analysis

Quick and Cheap Grip Test a Strong Measure of Frailty

By Christopher Cheney  
   May 17, 2018

For evaluating vascular surgery patients, a handheld device available on Amazon for $50 provides a low-cost and simpler alternative to other frailty measures.

Using a grip strength test to evaluate surgical patients for frailty is a high-value assessment, says the leader of a research team that published a study on grip strength testing this month.

"We were looking for something quick, easy, cheap, and reliable, and that is a rare combination in healthcare," says Matthew Corriere, MD, MS, an associate professor at the University of Michigan in Ann Arbor and a vascular surgeon at Michigan Medicine.

In vascular surgery, assessing patients for frailty is a key step, Corriere and his fellow researchers wrote. "Frailty is associated with adverse events, length of stay, and nonhome discharge after vascular surgery."

If a patient is found to be frail, it impacts medical decision-making and creates an opportunity for intervention, the researchers wrote.

"Accurate identification … might inform treatment or patient selection, enabling patients and providers to avoid (or at least to minimize) stressors and related risks. Frailty detection might also provide opportunities for prehabilitation through exercise, nutritional, and behavioral interventions to better prepare patients," according to the research paper.


Related: Frailty Index Helps Cut Readmissions, ICU Stays


Grip strength testing for frailty has multiple benefits, the researchers found. "Grip strength may have utility as a simple and inexpensive risk screening tool that is easily implemented in ambulatory clinics, avoids the need for imaging, and overcomes possible limitations of walking-based measures."

Testing grip strength is likely to be applicable in fields beyond vascular surgery, Corriere says. "Grip strength testing has potential in any field where you are trying to assess whether to provide a treatment, and trying to decide what the chances are of the patient having a normal life with or without that treatment."

He says other fields such as orthopedic surgery, cardiology, and general internal medicine practices—where physicians often face decisions on whether to refer patients for treatment—could benefit from grip strength testing.

'Low risk and low cost'

Grip strength testing has multiple advantages over other frailty tests, Corriere says.

The primary testing method for frailty is a walking speed test; however, many patients have walking impairments including peripheral artery disease and amputation that disqualify a walking test. Grip strength testing is appropriate for all patients as long as they do not have a hand or arm impairment such as arthritis, he says.

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


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