Grip strength as a translational biomarker for peripheral nerve injury and recovery

A central challenge in peripheral nerve injury care is determining whether an in-continuity injury will recover spontaneously or require early surgical intervention. This determination currently depends on serial observation, during which the window for effective intervention may narrow. This Perspective discusses grip strength as a translational biomarker for peripheral nerve injury and recovery, with emphasis on rodent forelimb nerve injury models. In both rats and human patients, grip strength can be used to assess whether a motor nerve can activate its target muscle sufficiently to generate force. This shared functional endpoint gives grip strength particular translational value and distinguishes it from many preclinical functional assays used only in animal research. In rodent models of in-continuity nerve stretch injury, structurally distinct injury grades have produced markedly different grip strength recovery profiles over time, linking structural injury severity to long-term functional outcomes. Grip strength has also served as a primary functional endpoint for evaluating intraoperative electrical stimulation as an early prognostic tool and for measuring treatment effects after nerve injury. The grasping test offers a practical, reliable and low-cost method for quantifying forelimb motor recovery, but broader adoption will require standardization of testing protocols and reporting. Grip strength should not be interpreted in isolation, as it reflects the combined function of nerve signaling and target muscle force generation. Instead, it is most informative when combined with histological, electrophysiological, sensory, imaging, and clinical assessments. Standardized use of grip strength may therefore improve the translational relevance of preclinical nerve injury research.