Nacul, Luis Carlos, Mudie, Kathleen, Kingdon, Caroline C et al. · Frontiers in neurology · 2018 · DOI
Researchers tested whether hand grip strength could be a useful tool for diagnosing ME/CFS and measuring how severe the condition is. They found that people with ME/CFS—especially those with severe disease—have noticeably weaker grip strength compared to healthy people, and their grip strength drops more across repeated tests. This simple, objective test may help doctors better diagnose ME/CFS and track how patients are doing over time.
ME/CFS diagnosis currently relies heavily on subjective clinical history, which can be inconsistent and delay diagnosis. This study provides evidence that hand grip strength—a simple, objective, low-cost measurement—could improve diagnostic accuracy and help identify disease severity, potentially enabling earlier recognition and better monitoring of treatment response. Establishing objective biomarkers is critical for both research and clinical practice to reduce diagnostic uncertainty.
This study does not prove that reduced grip strength causes ME/CFS or is the mechanism behind fatigue; it only demonstrates an association. The cross-sectional design cannot establish whether grip strength changes precede or follow ME/CFS onset. The findings cannot yet determine whether grip strength testing would replace clinical diagnosis or only serve as a complementary tool, nor do they establish optimal cutoff values for clinical use.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Nacul, Luis Carlos, Mudie, Kathleen, Kingdon, Caroline C, Clark, Taane G, & Lacerda, Eliana Mattos (2018). Hand Grip Strength as a Clinical Biomarker for ME/CFS and Disease Severity.. Frontiers in neurology. https://doi.org/10.3389/fneur.2018.00992
BibTeX
@article{mecfsatlas-nacul-2018-hand-grip,
author = {Nacul, Luis Carlos and Mudie, Kathleen and Kingdon, Caroline C and Clark, Taane G and Lacerda, Eliana Mattos},
title = {Hand Grip Strength as a Clinical Biomarker for ME/CFS and Disease Severity.},
journal = {Frontiers in neurology},
year = {2018},
doi = {10.3389/fneur.2018.00992},
note = {PubMed: 30538664},
url = {https://www.mecfsatlas.com/evidence/nacul-2018-hand-grip},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/nacul-2018-hand-grip
Contribute
Private, reviewed by a human. Not a public comment thread.