A Method for Checking Jamar Dynamometer

Calibration
Elaine Ewing Fess, MS, OTR,
FAOTA
Hand Research
Zionsville, Indiana
H
aving instruments that measure accurately
and consistently is critical to establishing
excellence in therapeutic intervention and research
endeavors.
I
-
3
Quantitative measurement permits as-
sessment of baseline pathology, prediction of reha-
bilitative potential, planning and evaluation of treat-
ment programs, and definition of final functional
capacity. By means of research reporting, quantitative
measurement also serves as a vehicle for professional
communication. The importance of utilizing the best
possible assessment instruments cannot be overstat-
ed.
Developed by Bechtol in 1954
4
and subsequently
recommended by three profes8i6nal societies,5-7 the
Jamar dynamometer has become a staple for those
involved in treating upper extremity dysfunction.
Serving both clinicians and researchers, the Jamar is
used not only to assess patient progress and the ef-
ficacy of treatment, but also has contributed signifi-
cantly to a better understanding of normal hand func-
tion. It has been the foundation of studies correlating
grip strength with height, weight, age, and hand
dominance,8 size of object grasped,4,9 and. motiva-
tion.I O,11 Unfortunately, because of inconsistency in
handle position,t2 altered instruments,8 an4 small
numbers of subjects in age subgroups,t3 normative
values for the dynamometer are inconsistent. Both
individuals
14
and professional groups6,7 have taken
important steps to standardize the use of the Jamar,
and two recent studies
1s
,16 have addressed its reli-
ability as a testing instrument. The latest of these
studies
l6
found that the Jamar dynamometer can be
a highly reliable assessment instrument, with corre-
lation coefficients of 16 of 20 new dynamometers
Reprint requests to Ms, Fess, 635 Eagle Creek Court, Zionsville, IN
46077.
28 JOURNAL OF HAND THERAPY
ABSTRACT: When calibrated correctly, the Jamar dynamometer
is a highly reliable assessment instrument, Utilizing an adjustable-
top workbench, positioning blocks, force collar, standardized test
weights, and a careful testing procedure, the ability of a Jamar
dynamometer to measure accurately and consistently may be eval-
uated. Resulting data may be plotted on graph paper for a general
estimate of measurement capacity, whereas calculation of the cor-
relation coeffiCient, mean of the standard weight applied, and
mean of the dynamometer readings provide a more exacting as-
sessment of instrument capacity. Dynamometers with a correlation
coefficient of 0.9994 or better and a difference between the means
of 1,5 pounds (0.68 kg) or less do not need recalibration. If the
correlation coefficient is acceptable but the difference between
the means is more than 1,5 pounds, the dynamometer may be
adjusted by the calibration screw on the face plate. When the
correlation coefficient is less than 0.9994, the instrument must be
returned to the manufacturer for recalibration.
ranging from 0.9999 to 0.9994 (l.0 equals perfect cor-
relation). It was also discovered in the same study
that of the 51 dynamometers evaluated (20 new, 31
used), 65% needed to be recalibrated.
While the theory of utilizing test instruments
that measure consistently and accurately is uncon-
testable, in practice clinicians and researchers alike
have been faced with a difficult dilemma. An accurate
method for checking the calibration of dynamome-
ters without sending them back to the manufacturer
has not been available. The purpose of this paper is
to present a simple and reliable method of assessing
the calibration of the Jamar dynamometer. To date
this method has been used to successfully evaluate
over 50 dynamometers.
EQUIPMENT
A commercially available adjustable split-top
workbench with stress tolerance to 350 pounds (158.76
kg) serves as the main structure for the work station
(Fig. 1).
Two blocks of wood position the dynamometer
handle posts in an attitude perpendicular to the table
surface (Fig. 2A). The vertical handle position is crit-
ical to accurate dynamometer testing. If the handles
are not vertical, a perpendicular application of force
(weights) cannot be attained, causing measurements
to be skewed. While the length and width of the
pOSitioning blocks remain constant (7.5 cm x 15 em),
the height of the blocks must be matched to the spe-
cific design of the dynamometer handle. Older dy-
namometers with offset handles require blocks with
heights of 2 cm and 5.5 em, respectively. Two blocks,
each 2 cm in height, are needed for the new lat-
handle design dynamometers. In order to stabilize
the positioning blocks in the table-top vice, a 2
FIGURE 1. A split-top bench serves as the main structure for
the work station.
cm x 2.5 cm x 7.5 cm piece of wood is bonded to
the center bottom surface of each block (Fig. 2B). Par-
alleling the shorter length, these i ~ e s allow the two
positioning blocks to be held securely when the hor-
izontal surfaces of the workbench are brought to-
gether. Final increments of height adjustment are
made by drilling a shallow indentation, 3.25 cm in
diameter, into the top middle portion of each block
approximately 1.5 cm from the edge. The "heels" of
the dynamometer handle posts fit into these inden-
tations (Fig. 2C), ensuring consistent dynamometer
placement on the blocks. The vertical orientation of
the handle posts should be checked with a bubble
level to verify that the depths of the indentations are
correct. Note: the longitudinal axis of the dynflmom-
eter must be parallel and center to the parallel grip-
ping surfaces of the table.
Constructed of two layers of thermoplastic ma-
terial with a central safety pin guide, a force collar
(Fig. 3) is fitted to the adjustable handle. This rigid
collar maintains the application of the weights in a
constant'position and distributes forces evenly along
the handle.
Standardized slotted interlocking metal test
weights, class F tolerance, provide accurate and con-
sistent forces against which dynamometer readings
I I
~
FIGURE 2. Top, Two blocks of wood position the dyna-
mometer handle posts in an attitude perpendicular to the table
surface; Middle, In order to stabilize the positioning blocks
in the table-top vice, an additional wood piece is bonded to
the center bottom surface of each block; Bottom, The "heels"
of the dynamometer handle posts fit into shallow drilled in-
dentations in the top middle portion of each block.
October-December 1987 29
flGUR.E 3. Fitted to the adjustable handle, a force collar
standardizes the point of application of the weights and dis
tributes pressure.
may be compared. These weights, in either avoir-
dupois pound or metric units, should provide a test-
ing range from 10 to 120 lb in 10-lb increments, or 5
to 55 kg in 5-kg increments. For stability and ease of
loading, a 52 cm hook extension is welded to one of
the metal weights at the time of purchase. To com-
pensate for the added weight of the hook, this welded
unit should be drill-calibrated to 10 lb or 5 kg to match
the other weights. Since these test weights are finely
calibrated, they should be handled and stored with
care, and they should not be used as therapeutic tools.
With the adjustable handle in position 5 and the
force collar in place, a double loop of 170 lb test nylon
cord is threaded through the force collar guide and
tied so that the top of the hook, when suspended
from the loops, falls 2 to 3 cm below the under surface
of the workbench top. As the cord loops pass through
the space between the platforms, they
should not contact the adjacent edges of the plat-
forms. Check to be certain that the weights are freely
suspended when the adjustable handle is in position
1 (smallest handle span). If the weights touch the floor
in this position, the double loop must be shortened.
TESTING PROCEDURE
After making certain that the workbench is on a
level plane and the positioning blocks are tightly
secured, place the dynamometer on the blocks and
check the handle posts with a bubble level to ensure
that they are perpendicular. With the force collar in
place, lock the adjustable handle in position 5 and
turn both the red and black dynamometer needles to
"0." Place the weighted hook through the double
loop and record the resultant needle reading on a
calibration check sheet (Fig. 4). Add a weight and
again record the resultant needle reading. Continue
adding and recording until all weights are suspend-
ed. Unload the hook, remove the hook from the dou-
ble loop, move the adjustable handle down one notch
to position 4, reset the needles, and begin the process
of adding weights and recording again. This proce-
30 JOURNAL OF HAND THERAPY
SERIAL NUMBR, ______ _ [JlHE' ______ _
CONDIT ION,
USO DA Tf OF PURCHASE , __ _
HANDlE POSITION
2
__ 3_
__5_
1o __ 1o __ 1o __ 1o __ 10 __
20 __ 2o __ 20 __ 20 __ 20 __
30 __ 30 __ 30 __ 30 __ 30 __
40 __
40 __ 40 __ 40 __ 40 __
5o __ 5o __ 5o __ 5o __ 5o __
60 __ 60 __ 60 __ 60 __ 60 __
70 __ 7o __ 70 __ 70 __ 70 __
8o __
80 __ 80 __ 80 __ 80 __
9o __
9o __ 9o __ 9o __ 9o __
10o __ 10o __ 10o __ 100 __ 10o __
110 __ 110 __ 110 __ 110 __ 110 __
120 __
120 __ 12o __ 120 __ 120 __
IAN OF STANDARD WEIGHTS,

IAN OF OYNAMIHTER VALUES,
CORRELATION COfFFICIENT,
graph at tached
FIGURE 4. Jaymar dynamometer calibration check sheet.
dure is carried out for all handle positions, working
down from the largest handle span to the smallest.
To maintain examiner objectivity, completed columns
(handle positions) on the flow sheet should be cov-
ered with a blank sheet of paper, and from reading
to reading it is critical that both the examiner's po-
sition and method be consistent.
ANALYSIS OF DATA
To organize test data in an understandable man-
ner, three factors must be derived from the infor-
mation on the flow sheet: (1) the correlation coeffi-
cient, (2) the mean of the standard weights, and (3)
the mean of the dynamometer readings.!7
It is important to define the correlation between
the amount of weight applied and the measurements
indicated by the dynamometer. This relationship may
be computed mathematically as a correlation coeffi-
cient. For the Jamar dynamometer it has been shown
that 0.9994 is a minimum level of tolerance.!6 Dyna-
mometers whose correlation coefficients are below
this standard cannot be adjusted to an acceptable level
and must be returned to the manufacturer for recal-
ibration. Either one or both of two problems may
cause the correlation coefficient to drop. The most
common problem occurs when portions of a given
test range (0-120 lb; 0-55 kg) vary markedly from the
remaining range. Although sometimes encountered
mid-range, those segments most frequently discrep-
ant may be found at either the lower or higher end
of the range, or both. Once the problem occurs, it is
often mirrored throughout all five handle positions.
Unfortunately, adjustment by a constant number of
units throughout the range cannot compensate for
the defection from a linear progression. The second
problem that results in a low correlation coefficient
occurs when there is a marked discrepancy between
handle readings. The dynamometer handle position
most often found out of calibration is the first posi-
tion.
16
Since all handle readings are affected equally,
adjustment by a constant number cannot restore the
problematic range to those of the other handles.
Both the standard mean (weights) for all trials
and the dynamometer reading mean for all trials must
also be calculated. The comparison of these two means
allows the examiner to identify the average amount
of discrepancy between the actual amount of weight
applied and the amount recorded by the dynamom-
eter.
Knowing the correlation coefficient and the dif-
ference between the two means provides an accurate
understanding of the calibration status of a given
dynamometer. If the correlation coefficient is 0.9994
or better and the difference between the means is 1.5
pounds (0.68 kg) or less, the dynamometer is mea-
suring at a very high level of accuracy and does not
need to be recalibrated. If the correlation coefficient
is good but the difference between the means is more
than 1.5 lb, the dynamometer may be adjusted (by
the amount of the difference between the means) us-
ing the calibration screw on the face plate. Finally,
when the correlation coefficient does not meet the
minimum standard, the dynamometer is unreliable
in its ability to measure. This problem cannot be ad-
justed with the calibration screw on the face plate
and the instrument must be returned to the manu-
facturer for recalibration. Note: the criteria of 1.5 lb
difference between the means is based on a trial to
trial mean standard deviation for those dynamome-
ters with correlation coefficients of 0.9994 or better,
of 0.545 lb (0.1758 lb) or 0.25 kg (0.08 kg).
The relationship describedJty.a correlation coef-
ficient may be plotted on graph. paper to provide a
quick non-mathematical visual interpretation (Fig. 5).
To fully understand the data obtained from a given
dynamometer, the ranges of all five handle positions
must be plotted on the graph. If all five lines follow
a similar pattern, then it is apparent that there is little
difference between the abilities of the different han-
dles to measure forces; and if these lines duplicate
the line of the standardized weights, the correlation
coefficient is within acceptable limits and the dyna-
mometer does not need recalibration. If, however,
one or more lines diverge from the others, the cor-
relation coefficient will be below acceptable levels.
As noted above, when one or more handles measure
differently than the others, the dynamometer should
be returned to the manufacturer for recalibration. If
the five lines remain together and parallel the course
of the standard weights, the correlation coefficient is
high but the values of the dynamometer readings are
off by a consistent amount throughout the test range.
As noted previously, when the readings are consis-
tently off by a given amount, the dynamometer may
be recalibrated by adjusting the calibration screw on
120
--- WEIGHT (pounds) APPLIED
110
----- DYNAMOMETER 'A'
100 - - - DYNAMOMETER'S'
c
90
DYNAMOMETER 'C'
!!!
....I
80 0..
0..
<
UJ 70
()
cr:
0
60
u.
u.
0
50
(fj
C
2
40 :::>
0
0..
30
20
10
o 10 20 30 40 50 60 70 80 90 100 110 120
MEAN OF 5 HANDLE POSITION READINGS
FIGURE 5. Comparison of mean values of three dynamom
eters indicates that instrument "A" may be recalibrated with
the calibration screw on the face plate, whereas "8" and "c"
must be returned to the manufacturer for recalibration. When
analyzing a single dynamometer, mean values are not used.
Real values are used to individually plot each of the five handle
positions.
the face plate, and the instrument does not need to
be returned to the manufacturer for recalibration.
Careful examination of the plotted values for the
five handle positions is important. While lines that
duplicate or parallel the track of the standardized
weights are easily apparent, how much divergence is
permissible for a line that gradually angles away but
remains within a O. 9994 level of reliability? Although
not infallible, in general if the mean value of the
handles does not diverge more than 3 lb (1.8 kg) at
any point from the standardized weight line, the cor-
relation coefficient for the dynamometer is probably
within acceptable limits. If, however, the mean value
moves from the standard line by more than 3 lb, the
reliability of the dynamometer is suspect and the cor
relation coefficient must be mathematically computed
to determine the reliability of the instrument.
TIMING
Depending upon use, dynamometers should be
checked a minimum of once a year. If they are used
on a daily basis, calibration checks should be done at
least every four to six months. Instruments used for
research require even more careful monitoring. Al-
though this may seem time-consuming at first, with
two experienced examiners (reader /recorder; weight
loader) the test process requires approximately 15 to
20 min, and calculating the data or plotting a graph
takes another 20 to 30 min. To put the issue in per-
spective, in a society oriented toward accountability,
an investment of one hour or less several times a year
is a small price to pay to ensure the accuracy of ther-
apeutic decisions based on grip-strength assessment.
October-December 1987 31
SUMMARY
When calibrated correctly the Jamar dynamom-
eter is a highly reliable assessment instrument. Uti-
lizing an adjustable-top workbench, positioning
blocks, force collar, and standardized test weights,
the ability of a dynamometer to measure accurately
and consistently may be evaluated. Resulting data
may be plotted on graph paper for a general estimate
of measurement capacity, and calculation of the cor-
relation coefficient, mean of the standard weight ap-
plied, and mean of the dynamometer readings pro-
vide a more exacting assessment of instrument
capacity.
REFERENCES
1. Fess EE: The need for reliability and validity in hand assess-
ment instruments. J Hand Surg llA:621-623, 1986.
2. Payton OD: Research: The Validation of Clinical Practice.
Philadelphia, FA Davis Co., 1984.
3. Fess EE: In Hunter J, Schneider L, Mackin J, Callahan A (eds):
Rehabilitation of the Hand, 2nd ed. St. Louis, CV Mosby Co.,
1984, pp 49-78.
4. Bechtol CD: Grip test: Use of a dynamometer with adjustable
handle spacing. J Bone Joint Surg 36A:820, 1954.
5. Kirkpatrick JE: Evaluation of grip loss: Factor of permanent
disability in California. Summation and conclusions of Sub-
committee for Study of Grasping Power of Committee on In-
dustrial Health and Rehabilitation of California Medical As-
sociation. Calif Med 85:314-320,1956.
6. American Society for Surgery of the Hand: The Hand: Exam-
ination and Diagnosis, 2nd ed. New York, Churchill Living-
stone, 1983.
7. American Society of Hand Therapists: Clinical Assessment Rec-
ommendations. ASHT, Garner, North Carolina, 1981.
8. Schmidt R, Toews J: Grip strength as measured by the Jaymar
dynamometer. Arch Phys Med Rehabil51:321-327, 1970.
9. Fess, EE: The effects of Jaymar handle position and test protocol
on normal grip strength. J Hand Surg 7:308,1982.
10. Murray J: The patient with the injured hand. Presidential ad-
dress, American Society for Surgery of the Hand. J Hand Surg
. 7:543,1982.
11. Hildreth, D: The Jaymar dynamometer. J Hand Surg llA:768,
1986.
12. Kellor M, Frost J, Silberg N, et al: Hand strength and dexterity.
Am J Occup Ther 25:77-83,1971.
13. Mathiowetz V, Kashman N, et al: Grip and pinch strength:
Normative data for adults. Arch Phys Med Rehabil 66:69-74,
1985.
14. Mathiowetz V, Rennells MS, Donahoe L: Effect of elbow po-
sition on grip and key pinch strength. J Hand Surg 10A:694-
696,1985.
15. Mathiowetz V, Weber K, et al: Reliability and validity of grip
and pinch strength evaluations. J Hand Surg 9A:222-226, 1984.
16. Fess EE: Reliability of the Jaymar dynamometer. Submitted for
publication.
17. Swinscow TDV: Statistics at Square One. London, British Med-
ical Association, 1983.
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