Handgrip strength testing in rheumatic diseases

Rheumatic diseases encompass diverse immune-mediated disorders that compromise musculoskeletal and systemic functions, often resulting in persistent disability. Hand muscle weakness is an early and clinically meaningful manifestation across rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and systemic sclerosis (SSc). Reduced handgrip strength (HGS) is an integrative measure that reflects systemic inflammation, neuromuscular involvement, and functional deterioration, providing critical insight into disease progression. The current review aims to overview available evidence on HGS testing in rheumatic diseases, with a focus on measurement devices, clinical and prognostic significance, and perspectives for its integration into disease monitoring and patient management. HGS is a sensitive marker of muscular function and frailty. Advances in mechanical and digital dynamometry, wearable devices, and smartphone-integrated systems enable precise and remote assessments. Reduced HGS correlates with higher disease burden and impaired quality of life. Despite its growing applicability, heterogeneity in testing procedures and inter-device variability underscore the need for standardized protocols and device-specific reference values. Advances in wearable sensors, digital dynamometry, and AI-supported telerehabilitation hold promise for integrating HGS into personalized disease monitoring.