Indian Journal of physiotherapy, Vol 45, No 2 (March): pp 116-121

Does the dominant hand possess 10% greater grip strength than the non dominant hand?
Rama Krishna Gedela, MSPT, Alanah Kirby, MSPT, Heini Huhtala, MSc

Background: The 10% rule states that the dominant hand possesses 10% more grip strength than the non dominant hand. The 10% rule has been used for many years to plan out strength goals and rehabilitation programmes
in patients with hand injuries .The purpose of the study was to test the utility of the 10% rule in hand rehabilitation
and to verify whether the 10% rule applies to both left and right handed subjects. Sample size: The sample for the
study consisted of 40 healthy physiotherapy students. Methodology: Grip strength was measured using a standard
Jamar Dynamometer which was calibrated before and after data collection to ensure the data collected was accurate. Standardised positioning (ASHT) and verbal instructions were used. Three trials were conducted for each arm,
with one minute rest periods to counteract fatigue. Results: Results showed an over all 10.02% grip strength difference between the dominant and non dominant hand there by proving the 10% rule as valid. However when separate analysis of the right handed and left handed subjects was done, a 10.37% difference for right handed subjects
and a 8.16% difference for the left handed subjects was found. Conclusion: The study showed that the 10% rule
was valid for right handed persons alone. In the case of left handed persons the grip strength must be considered
equal in both hands.
Index words: grip strength; dominance; Jamar dynamometer; muscle strength; Dynamometry

The upper limb particularly the hand proves

This rule states that dominant hand has 10%

paramount to daily life. The hand has a central

greater strength than the non dominant hand 3.

role in many activities of daily life like eating,

In 1954, Betchol

writing, typing, etc, the list is endless. Loss of

presented a difference of around 5 to 10%

optimal hand function does not merely hamper

between their dominant and non-dominant hands

practical tasks such as personal hygiene it

on grip strength measurements. A number of

affects other areas of the life 1. Grip strength

studies have since been conducted to establish

measurement is an important component of

normative data for grip strength measurements to

hand rehabilitation because it assesses the

be

patients initial limitation as compared to the

rehabilitation programmes. A study done by

norms 2. In cases of hand injury or disease,

Mathiowetz et al 4 revealed that the grip strength

clinicians commonly incorporate grip strength

of the right hand was stronger than the grip

in their assessment procedure to evaluate the

strength in the left hand. Separate analysis of left

effectiveness of rehabilitation intervention. The

hand and right hand data revealed little functional

10% rule is often used by the clinicians in goal

difference in the mean scores. This finding did

setting.

not support the 10% rule. Lunde et al 6 conducted

From the Department of physiotherapy ,

Queen Margaret University, Edinburgh.
Received February 7, 2008: accepted in revised
form March 1, 2008. Online manuscript submission
and reviews
http://indianjournalofphysiotherapy.net
Address reprint requests to Rama Krishna Gedela,
MSPT. E-mail: kishangedela@yahoo.com
2008 by Indian Journal of physiotherapy

used

as

observed that most patients

treatment

guidelines

in

the

a three year study to examine the nutritional status

of 57 college women. Grip strength was one of
the many variables that were measured. The data
for the grip strength variable consisted of 107
measurements. The results indicated that there

Indian Journal of physiotherapy, Vol 45, No 2 (March): pp 116-121

was a 13% grip strength advantage in dominant hand when compared to non-dominant hand. However
a review of the data for each measurement revealed that 24% of the 107 measurements had showed
strength readings equal to or greater than the dominant hand.
Schmidt and Toews 7 in a larger study of 1,128 males and 80 females tested grip strength as a part of
the physical examination for employment at a large manufacturing firm. The results indicated a 10.3
strength advantage in dominant hand as compared to non-dominant hand, thus supporting the 10% rule.
When the individual scores were examined they found that 22.6% of the men were stronger in their
non-dominant hand and 5.4% had equal grip strength in their dominant and non-dominant hand. On
the basis Schmidt questioned the application of the 10% rule in such areas as workers compensation 7 .
Swason et al 8 conducted a study of 50 men and 50 women. The results indicated that the grip
strength of the non-dominant hand was equal to or greater than that of the dominant hand in 29% of the
subjects.

In the above three studies 24-29% of the subjects had grip strength readings in their non-dominant hand
that were equal to or greater than the grip strength readings of the dominant hand 6-8. On the basis of
this alone the utility of the 10% rule can be challenged. However none of these studies addressed right
or left hand grip strength differences in relation to the dominance 6-8. The aim of the present study is to
determine if there is a significant difference between grip strength of the dominant and non-dominant
hand, and to qualify if this difference agrees with the 10% rule. Further this study also aims to
investigate whether or not the 10% rule applies for both right and left handed individuals or does it need
to be modified.

METHOD

A convenient sample of 40 university physiotherapy students (12 females and 28 males) volunteered to
participate in this study. Ages ranged from 17 to 26 years (mean 21.9 years 0.57). Self report
established that six were left hand dominant (four males and two females). EHI10 was used to verify
the hand dominance. Subjects were not paid for their participation. The study was advertised through
the moderator in the college web mail and posters placed in location of high visibility. Some subjects
were also recruited through personal communication of the researchers.
A standard, adjustable hand held Jamar Hand Dynamometer (JHD) was used to measure grip strength.
The second position (of the 5 positions available) was used as recommended by Kellor et al 8.

Indian Journal of physiotherapy, Vol 45, No 2 (March): pp 116-121

The dynamometer was reset to zero prior to each

reading of the grip strength. Suspended weight
calibration was performed before and after the
data collection process to ensure the accuracy of
the data collected. Linear correlation was used to
analyse the association between suspended
weights during calibration and the actual reading

Figure 1.1
Standard position recommended by ASHT

on the JHD. The correlation between the two variables was r=0.99, with p-value of p<0.001.
A brief interview was conducted with each subject to familiarise him with the procedure and
the equipment. Hand dominance was established by asking each subject are you right or lefthand dominant and verified using Edinburgh Handedness Inventory. The interview ended with
the subject signing the consent form. Each subject was seated in a standard height chair with no
arm rests. Feet were flat on the floor and approximately shoulder width apart. Standard position
recommended by the American Society of Hand Therapists was used: the subject was seated
with shoulders abducted and neutrally rotated, elbow flexed at 90 degrees, and the forearm and
the wrist in neutral position. The subjects were verbally instructed to maintain their arm by their
side with their shoulder in neutral position Similarly they were instructed not to excessively
brace their arm against their trunk and also not to abduct their arm. The subjects were also instructed to keep their wrists as neutral as possible although mild wrist extension is expected with
power grip ( 0 -30 degrees of wrist extension is permissible by ASHT)

To counterbalance any order effect from the starting hand, every other subject began with their
right hand, while those in between began with their left hand. After the subjects had sufficient
time to familiarize themselves with the dynamometer, the grip bar of the dynamometer was set
for each subject. Three trials were conducted, alternating right and left hands. The same researcher read the dynamometer dial to record the various trials. The average of the three trials
was recorded for each hand. The percentage difference between the hands was calculated by dividing the score of non-dominant hand with the score of the dominant hand and the value obtained was subtracted from one. The scores of the right hand and left hand were expressed in
kilograms and the percent difference score, expressed as percentage.

Indian Journal of physiotherapy, Vol 45, No 2 (March): pp 116-121

Results
The data collected was analysed using the SPSS (version 12) statistical package. All the data
was normal and ratio in nature thus parametric tests were used to assess if there was significant difference between the dominant and non dominant hand. Mean grip strength values
obtained using JHD showed 15% of the subjects (n=6) showed greater grip strength in their
non-dominant hand in comparison to their dominant hand grip strength. A paired sample
t-test was used to assess if there was any significant difference between the dominant and
non-dominant hand. Paired samples t-test was also used to do separate analysis of left and
right handed subjects to assess if there was a significant difference between their dominant
and non-dominant hand. Values equal to or less than 0.01 were accepted as significant
(p<0.01). Since the number of left handed persons was small (n=7), the Wilcoxon test which
is a non-parametric equivalent of paired t-test was conducted to assess whether there was
significant difference between the dominant and non-dominant hands of the left handed subjects. No significant difference (p=0.091) was found across the group.

Table 1.1 Summarising data for Left handed and right handed subjects

The mean percentage difference for the left handed subjects was lower than for the group as
a whole, at just 8.16. When subdivided according to sex it was found that left handed women had a mean percentage difference of 12.2 between their left and right hands, compared to
6.5 for the left handed males. To assess if there was any significant difference between the
dominant and non-dominant hands of the right handed subjects a paired samples t-test was
conducted. A highly significant difference (p<0.001) was seen across the group. The mean
percentage difference for the right handed subjects was 10.37% (n=33). When subdivided

Indian Journal of physiotherapy, Vol 45, No 2 (March): pp 116-121

according to sex right handed men had a mean percentage difference of 11.8% while right handed
women has a value of just 7.4%. A paired samples t-test was conducted to investigate if there was
any difference between the values for the left and right hands. A Pearson's correlation of r=0.98 was
achieved, thus illustrating that the variables are highly correlated. The paired samples t-test was statistically significant(p<0.01) and therefore can be accepted at 1% level.

DISCUSSION

An overall 10.02% grip strength difference was observed across subjects. This finding supports that
the dominant hand is about 10% stronger than the non-dominating hand. However the same data
showed that a 15% of the sample (6 out of 40 subjects) possessed greater grip strength in their nondominant hand as compared to their dominant hand. The general consensus when setting strength
goals for patients undergoing rehabilitation programs for the upper extremity has been to expect a
10% greater grip strength from the dominant hand, irrespective of whether the patient is left or right
dominant. The results of the study indicate that it is appropriate for the right handed patients only.
For left handed patients however the rule does not apply. To set goals for these patients clinicians
should use normative data or consider both hands to be equivalent in strength. The mood of the subject and the tester was a factor which could not be controlled and may have influenced the results if
either of them was not working to the best of their ability. In assessing grip strength in hand a maximal squeeze is very subjective. It is impossible to predict the motivation and the effort the subject
puts into performing the maximal contraction. To minimise this potential error clear concise verbal
instructions were given as recommended by Mathiowetz et al 5. Strict criteria specified that any subjects who had encountered any upper limb injury, disease or surgery in the year prior to testing be
excluded, thus resulting in all subjects being normal. Although it is important to understand how
grip strength is effected by the hand dominance in persons without impairments, for comparative
reasons, the relationship between the grip strength and hand dominance may necessarily not be the
same in subjects with upper extremity abnormalities. Therefore the results obtained from this research study apply only to a group of healthy normal subjects, and cannot be applied to those with
upper limb dysfunction. The present study recruited students between 17 - 26. Incorporating a broad
range of ages, occupation, social groups and subjects with upper limb abnormalities will increase the
applicability of the results to wider population. The greater percentage difference demonstrated by
the right handed subjects between dominant and non-dominant hands may be explained by the fact
that we live in a right handed world. Our civilization has been built around a tradition that regards
the right hand as preferable to the left. Hand tools, machines, even doors were designed on the bases

Indian Journal of physiotherapy, Vol 45, No 2 (March): pp 116-121

of this attitude thereby leaving the left handed people with no option but to use their non dominant
hand far more than their dominant hand. As a result, the right hand of both the right and left handed
people is utilised in functional tasks more often than the left hand on daily may account for the results obtained.

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