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PubMedDate not supplied

Hand grip dynamometry as a predictor of postoperative complications reappraisal using age standardized grip strengths.

A mechanical hand grip dynamometer was used to derive age- and sex-related standard grip strengths from 247 healthy volunteers between 16 and 95 yr old. Preoperative grip strength was measured in 90 patients and related to postoperative complication rates. A grip strength of 85% standard for age and sex was found to be the most effective cut-off for prediction of postoperative complications in terms of sensitivity and specificity, predicting 74% of the complications (p less than 0.05). Specificity is improved over previously published standards related to sex alone especially when assessing the elderly patient (50% vs 21%). A grip strength below the recommended cut-off for age and sex suggests that the patient is in a high-risk group and demands further investigation of nutritional status. Studies of pre-operative nutritional support for the at risk group need to be undertaken.

Adolescent↗
PubMedDate not supplied

Impact of elbow position on grip strength of elderly men.

Grip strength is frequently measured in rehabilitation settings in order to monitor patient progress. Many factors influence grip strength measurements, including body segment positions and particularly elbow position. The objective of this study was to compare grip strength measurements obtained with two different elbow positions: full extension and 90 degrees of flexion. Forty-nine healthy right-handed men aged 60 to 84 years were tested with a Jamar dynamometer. Results indicated that left grip strength was significantly higher when the elbow was flexed to 90 degrees compared with when it was fully extended. No statistical difference between the two elbow positions was found for the dominant hand.

Aged↗
PubMed1997

Quadriceps and grip strength are related to vitamin D receptor genotype in elderly nonobese women.

Osteoporotic fragility fractures are related to bone density and injury, which are both related to muscle strength. The influence of genetic factors, such as the vitamin D receptor (VDR) polymorphism on bone mineral density (BMD), is documented but still controversial, and is not known for muscle strength. In the present study, we investigated the association between the VDR BsmI polymorphism and BMD (femoral neck [FN], lumbar spine [LS], and proximal forearm [FA]) and muscle strength (quadriceps and grip strength) in 501 healthy women older than 70 years. No association was found between the VDR genotypes and BMD in elderly women. However, in nonobese women (body mass index <30 kg/cm2), the BMD in the FN was 5% higher in women with the bb BsmI genotype than in women with the BB genotype (p < 0.05). After correction for muscle strength, no association was found. A significant association between the VDR genotypes and quadriceps and grip strength was observed. In nonobese women, a 23% difference in quadriceps strength (p < 0.01) and 7% in grip strength (NS) was observed between the bb and BB genotype of the VDR. After correction for confounding factors and BMD, this association was significant for quadriceps and grip strength. These results indicate a major association of an allelic variant at the VDR locus with muscle strength in elderly nonobese women, which could explain a small association between VDR polymorphism with BMD in the femoral neck in nonobese women. No such associations were found in obese women, suggesting that factors related to obesity obscure such an association.

Aged↗
PubMed1997

Posture effects on grip strength.

OBJECTIVE: To examine whether grip strengths were different when measured in supine and sitting positions. DESIGN: Comparison, convenience sample. SETTING: Community. PARTICIPANTS: Seventy-four healthy adult participants with no history of psychiatric or neurological dysfunction, or upper extremity orthopedic dysfunction after the age of 18. INTERVENTIONS: Participants performed grips with each hand while sitting and standing. Shoulder was adducted and extended, with the elbow flexed, and wrist and forearm in neutral. MAIN OUTCOME MEASURE: The mean of the three trials with each hand in each posture. RESULTS: Men were stronger (49kg) than women (29kg; p < .001). Right hands were stronger (41kg) than left (39kg; p < .001). However, grip strengths while sitting were equivalent to those tested while supine (p > .59). CONCLUSIONS: Using identical upper extremity positions, grip strength is equivalent when tested in the supine and sitting positions. Thus, when determining grip strength, grips measured while the subject is supine can be compared with norms collected while the subject is sitting, provided the upper extremity position is invariant.

Adolescent↗
PubMed2006

Occupational and other risk factors for hand-grip strength: the Honolulu-Asia Aging Study.

BACKGROUND: In certain occupations, including farm work, workers are exposed to hazardous substances, some of which are known to be toxic to the nervous system and may adversely affect muscle strength. Measurement of hand-grip strength may be useful for detecting neurotoxic exposure. METHODS: The authors studied 3522 participants of the Honolulu Heart Program and the Honolulu-Asia Aging Study to determine whether occupational exposures to pesticides, solvents, and metals assessed at exam I (1965-68) are associated with hand-grip strength at exam IV (1991-93) and change in hand-grip strength over 25 years. Correlation, analysis of variance and covariance, and linear regression were used to evaluate the associations. RESULTS: At exam IV, participants ranged in age from 71-93 years; mean hand-grip strength was 39.6 kg at exam I and 30.3 kg at exam IV. Over 25 years, the decline in hand-grip strength was an average of 8-9 kg for all exposures. Hand-grip strength was inversely associated with age and glucose but directly associated with cognitive function, BMI, and haemoglobin level. No other exposures were associated with hand-grip strength. CONCLUSION: This study did not provide evidence that occupational exposure to pesticides, solvents, and metals adversely affected hand-grip strength in this population, but confirmed other important associations with hand-grip strength.

Aged↗
PubMedDate not supplied

Normative data for grip strength of elderly men and women.

OBJECTIVES: Grip strength is an important prerequisite for good performance of the upper limb, hence it is important to evaluate it correctly. However, one of the main difficulties in evaluating the grip strength of elderly patients is the absence of valid norms. Therefore, the objective of this study was to develop normative data for maximum grip strength of persons aged 60 years and older. METHOD: The grip strength of 360 subjects aged 60 years and older, randomly recruited by age and gender strata, was evaluated with the Jamar dynamometer and the Martin vigorimeter according to the protocol of the American Society of Hand Therapists. RESULTS: Grip strength diminishes curvilinearly with age, and men are consistently stronger than women. The data are presented by the means, standard deviations, and range, and as predictive equations obtained by regression analysis. In addition to age and gender, hand circumference and body height proved to be the best indicators of grip strength for this population of elderly subjects. CONCLUSION: The random recruitment of subjects, the high participation rate in the study, and the comparability of the subjects who agreed to participate and those who refused give this study the high external validity that is essential to any norm study. The predictive equations will help occupational therapists to better estimate the expected grip strength of elderly patients than they could if using only age and gender.

Age Factors↗
PubMed1994

Performance of normal Chinese adults on grip strength test: a preliminary study.

This study investigated grip strength performance in normal Chinese adults. Grip strength of 160 Chinese subjects (80 males and 80 females) from a major metropolitan city in southern Taiwan was measured with a newly calibrated Jamar dynamometer. The subject was tested in a standing position, with shoulder adducted and neutrally rotated, elbow flexed at 90 degrees and forearm and wrist in neutral position. Subjects exerted one maximal effort with both right and left hands. Results indicate that the grip strength of Chinese males peaked within the 20 to 39 year-old group. For Chinese females, the highest grip strength score occurred in the 40 to 49 year-old age group and declined as a function of age. Males consistently had higher grip strength than females across age ranges. Finally, there was no 10% variance in grip strength from the dominant to nondominant hand for each age group of both sexes. Instead, there were 49 (31%) of all subjects who had nondominant hand strength scores that were equal to or greater than their dominant hand strength scores. Clinical implications and recommendations for future research are suggested.

Adult↗
PubMed1989

A possible proximity effect on human grip strength: an attempted replication.

A double-blind experiment with 50 adults was conducted to replicate a finding that proximity to sugar reduces human grip strength. Grip strength of the dominant hand was measured by a chart-recording hand dynamometer for 12 trials. For half of the trials, the subject held an opaque, sealed bottle containing sugar; for half of the trials, the subject held a control bottle of equal weight containing sand. Statistical analysis indicated no significant effect of held substance upon grip strength.

Adolescent↗
PubMed2001

Grip strength in children.

The grip strength in a group of 487 healthy children aged between 5 years and 15 years was measured. There was a clear correlation between age and grip strength. Up to the age of 12 years, there was a striking parallellism between boys and girls. From the age of 13 years, boys developed a 25% stronger grip force than girls. The difference between the dominant and nondominant hand grip was not significant, but was constantly stronger in the right hand for right-hand dominant children. There was a high variation in grip forces (from 6.9 kg to 38.4 kg).

Adolescent↗
PubMed2002

The rapid exchange grip strength test and the detection of submaximal grip effort.

This study assessed the reliability of the rapid exchange grip test for detecting submaximal grip effort, particularly evaluating its performance with motivated subjects with genuine hand weakness secondary to pain. Fifty normal participants performing with maximum effort then feigning hand weakness and 50 patients recovering from carpal tunnel surgery were studied. The results showed that the dynamic measure of grip strength equaled or exceeded the static measure in 28% of maximally performing participants (72% specificity), 58% of the carpal tunnel decompression patients (42% specificity), and 74% of participants giving submaximal grip effort (74% sensitivity). Sensitivities and specificities for other criteria of a positive test were also determined. Our findings suggest that the rapid exchange grip strength test cannot reliably detect voluntary submaximal effort.

Adult↗
PubMed2001

Interpersonal and intrapersonal variance of exponent of power function observed in grip strength task.

For grip strength there is a power function with an exponent of 1.7 between the subjective magnitude and the actual force exerted by a subject, but large variabilities among and within individuals were found. We focused on these variabilities and investigated the relationship between them by conducting a ratio production procedure requiring trials of maximum effort and half of maximum effort. For 30 adults we conducted four measurement trials, two on the same day, and the remaining two trials on a day or two later. The mean value of the exponent, the standard deviation, and the coefficient of variation of the four trials for each subject were calculated. The mean value of the exponent of the power function for all subjects was 1.6. This value approximated the value of 1.7 reported by Stevens and Mack. The values ranged from .50 to 5.39. The correlation between subjects' mean exponent value and standard deviation was .90, and the correlation between the mean value of the exponent and the coefficient of variation was .50. There was a close relationship between interpersonal and intrapersonal variance.

Adult↗
PubMed2001

Grip strength measurement in competitive ten-pin bowlers.

BACKGROUND: In an attempt to find a more specific grip strength test for bowlers, the conventional grip strength test was modified such that only the fingers used in holding the ball are tested. The objective of this study was to assess the test-retest reliability of this modified bowling grip strength test, to assess the agreement between the bowling and the conventional grip strength tests, and to examine the correlation between the modified test and bowling performance in competitive bowlers. METHODS. EXPERIMENTAL DESIGN: This research was conducted in two parts, each with a different study sample. Study I was a cross-sectional study to assess the correlation between the bowling grip strength and the bowling score. Study II was a comparative study to obtain the test-retest reliability for both the bowling and conventional grip strength tests, and to assess the agreement between the two tests. SETTING AND SUBJECTS: for study I, the subjects were 39 members (26 males and 13 females) of the Singapore National Ten-Pin Bowling Training Squad. Bowling grip strength was measured within one month prior to the selection trials for the national squad, the results of which were used as a measure of bowling performance. For study II, the subjects were 21 members (12 males and 9 females) of the Singapore National Ten-Pin Bowling Squad that was formed after the selection trials. INTERVENTIONS: none. MEASURES: Bowling grip strength, conventional grip strength, and bowling score. RESULTS: The test-retest reliability of the bowling grip strength measurement (r = 0.91, p < 0.01) was comparable to that of the conventional five-finger grip (r = 0.93, p < 0.01). The single measure intraclass correlation coefficient between the bowling and conventional grip strength tests was 0.77; the 95% confidence interval was 0.51 and 0.90. However, the correlation coefficient between the bowling grip strength test and bowling score (r = 0.27) was not significant. CONCLUSIONS: The bowling grip strength test has a high test-retest reliability, and a moderate agreement with the conventional grip strength test. However, despite using only the bowling fingers, the test was unable to predict bowling performance in elite bowlers.

Adolescent↗
PubMed1988

The effects of cold immersion and hand protection on grip strength.

The maximal voluntary grip strength (MVGS) of male volunteers was examined following a series of five intermittent 2 min cold water (5 degrees C) immersions of the unprotected hand or forearm. MVGS changes due to wearing a protective glove were also investigated. The surface electrical activity over the hand flexor muscles was recorded, as was the skin temperature of the hand and forearm. MVGS decreased significantly (p less than 0.01) following hand immersions (16%) and forearm immersion (13%). The majority of these reductions occurred during the first 2-min period of immersion. The effect of wearing a glove after unprotected hand cooling also produced significant (p less than 0.01) MVGS reductions which averaged 14%. These reductions were in addition to those caused by hand cooling. We conclude that both hand and forearm protection are important for the maintenance of hand-grip strength following cold water immersion.

Adult↗
PubMedDate not supplied

Genetic influences and grip strength norms in the NHLBI twin study males aged 59-69.

Maximal grip strength was measured in kilograms using a hand dynamometer on 344 unrelated males between the ages of 59 and 70 participating in the third examination of the NHLBI Twin Study. There was a significant linear decline in mean grip strength over this age range. Mean grip strength and grip strength per kilogram weight are presented for age 59, ages 60-64 and 65-69. Genetic analysis using 127 pairs of identical (MZ) twins and 130 pairs of fraternal (DZ) twins indicated significant genetic effects for absolute grip strength and grip strength per kilogram weight. The largest estimate of heritability (65%) was obtained for grip strength adjusted for significant effects of weight, height, age, and various anthropometric measures of fatness, muscle mass, and frame size.

Age Factors↗
PubMed1990

The role of muscle loss in the age-related decline of grip strength: cross-sectional and longitudinal perspectives.

The decline of strength with age has often been attributed to declining muscle mass in older subjects. To investigate factors which might influence changes in strength across the life span, grip strength and muscle mass (as estimated by creatinine excretion and forearm circumference) were measured in 847 healthy volunteers, aged 20-100 years, from the Baltimore Longitudinal Study of Aging. Cross-sectional and longitudinal results concur that grip strength increases into the thirties and declines at an accelerating rate after age 40. However, the grip strength of 48% of subjects less than 40 years old, 29% of individuals 40-59 years old, and 15% of subjects older than 60 did not decline during the average 9-year follow-up. Grip strength is strongly correlated with muscle mass (r = .60, p less than .0001). However, using multiple regression analysis, grip strength is more strongly correlated with age (partial r2 = .38) than muscle mass (partial r2 = .16). Additionally, a residuals analysis demonstrates that younger subjects are stronger and older subjects are weaker than one would predict based on their muscular size. Thus, while strength losses are partially explained by declining muscle mass, there remain other yet undetermined factors beyond declining muscle mass to explain some of the loss of strength seen with aging.

Adult↗
PubMedDate not supplied

A literature review of the effect of handedness on isometric grip strength differences of the left and right hands.

When estimating preinjury grip strengthfor compensation and rehabilitation purposes, two methods have been identified in the literature: (a) comparison with the unaffected hand and (b) reference to grip strength normative data. The literature is divided about whether a significant difference exists between the grip strengths of a person's two healthy hands. Some researchers argue that handedness affects the grip strength ratio. According to these authors, there is considerable variation in the definition of handedness, its effect on grip strength ratios, and the methods of assessing handedness as it relates to grip strength. The complexity of defining and accurately evaluating handedness is discussed in this literature review. Inappropriateness of the current use of self-report questionnaires for determining handedness for grip strength purposes is highlighted. The impact of the effect of handedness on grip strength ratios cannot be clarified until a consistent definition and evaluation method for assessing handedness is developed. This handedness definition then needs to be applied to appropriately designed hand grip strength studies.

Female↗
PubMed2002

Interobserver reproducibility of the assessment of severity of complaints, grip strength, and pressure pain threshold in patients with lateral epicondylitis.

OBJECTIVE: To evaluate the interobserver reproducibility of the assessment of severity of complaints, grip strength, and pressure pain threshold in patients with lateral epicondylitis in primary care. DESIGN: Two physiotherapists assessed independently, and in randomized order, the severity of complaints scored on an 11-point numeric rating scale, pain-free grip strength, maximum grip strength, and pressure pain threshold. SETTING: Primary care center in the Netherlands. PARTICIPANTS: Fifty patients were assessed by both physiotherapists. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Intraclass correlation coefficients (ICCs) and 95% confidence intervals (CIs) were calculated to assess interobserver reliability. The Bland and Altman method was used to assess interobserver agreement, which included calculation of the mean difference between the observers (d), the 95% CI for d, the standard deviation of the differences, and the 95% limits of agreement. Finally, the smallest detectable difference (SDD) was calculated. RESULTS: The ICC for the severity of complaints was.90. The ICCs for the pain-free grip strength and maximum grip strength were.97 and.98, respectively. The pressure pain threshold showed a lower reliability (ICC=.77). The interobserver agreement for all outcome measures was good, but systematic differences in assessment between the physiotherapists were found for the maximum grip strength and pressure pain threshold. For pressure pain threshold, the SDD was clearly larger than the predefined acceptable difference of 10% of the total range of measurement. CONCLUSIONS: The interobserver reliability of severity of complaints and grip strength was excellent, whereas the pressure pain threshold showed unsatisfactory reliability. Grip strength and overall assessment of the severity of complaints are useful and reliable measures for the assessment of lateral epicondylitis. Pain-free grip strength, in particular, is relatively easy to perform and has been shown to be associated with other measures of functional disability in patients with lateral epicondylitis. We, therefore, recommend the use of pain-free grip strength in both research and clinical practice.

Adult↗
PubMed2006

Hand-grip strength of young men, women and highly trained female athletes.

Hand-grip strength has been identified as one limiting factor for manual lifting and carrying loads. To obtain epidemiologically relevant hand-grip strength data for pre-employment screening, we determined maximal isometric hand-grip strength in 1,654 healthy men and 533 healthy women aged 20-25 years. Moreover, to assess the potential margins for improvement in hand-grip strength of women by training, we studied 60 highly trained elite female athletes from sports known to require high hand-grip forces (judo, handball). Maximal isometric hand-grip force was recorded over 15 s using a handheld hand-grip ergometer. Biometric parameters included lean body mass (LBM) and hand dimensions. Mean maximal hand-grip strength showed the expected clear difference between men (541 N) and women (329 N). Less expected was the gender related distribution of hand-grip strength: 90% of females produced less force than 95% of males. Though female athletes were significantly stronger (444 N) than their untrained female counterparts, this value corresponded to only the 25th percentile of the male subjects. Hand-grip strength was linearly correlated with LBM. Furthermore, both relative hand-grip strength parameters (F (max)/body weight and F (max)/LBM) did not show any correlation to hand dimensions. The present findings show that the differences in hand-grip strength of men and women are larger than previously reported. An appreciable difference still remains when using lean body mass as reference. The results of female national elite athletes even indicate that the strength level attainable by extremely high training will rarely surpass the 50th percentile of untrained or not specifically trained men.

Adult↗