The administration and interpretation of the rapid exchange grip test: a national survey

The purpose of the present study was to determine if the administration and interpretation of the rapid exchange grip (REG) test vary among hand therapists nationally. The REG is used to determine sincerity of effort of grip strength. There are inconsistencies in the literature regarding the administration and interpretation of the REG, as various studies use different testing protocols and diverse interpretation criteria for what constitutes a sincere effort. As a result, we expected to find a lack of standardization in the administration and interpretation of the REG in clinical practice. We conducted a random nationwide survey of 200 hand therapists. The questionnaire items regarding the administration of the REG included patient position, test instructions, handle settings, handling of the dynamometer, hand switch rate, number of repetitions, and techniques used to record the score. The items for the interpretation of the REG involved questions regarding comparative tests. We found that the REG test lacks standardized administration protocols and interpretation criteria among therapists nationwide. The lack of standardization is likely to affect the reliability and validity of the REG and to hinder the therapist's ability to accurately report its outcomes. The implications of lack of standardization in assessment techniques to the profession are discussed.