Handgrip Strength Asymmetry Research Articles

Association of handgrip strength weakness and asymmetry with later life pain risk in middle-aged and older individuals: Results from four prospective cohorts.

The burden of pain in middle-aged and older adults is considerable and significantly increases healthcare expenditures. We aimed to investigate the roles of handgrip strength (HGS) weakness and asymmetry in predicting pain across four nationally representative cohorts. This longitudinal study utilized data from four major surveys: the Health and Retirement Study (HRS); the English Longitudinal Study of Ageing (ELSA); the Survey of Health, Ageing and Retirement in Europe (SHARE); and the China Health and Retirement Longitudinal Study (CHARLS). Multivariable cubic regression splines were employed to visually explore the nonlinear associations between HGS and pain in each cohort. The Cox proportional hazard model was applied to analyze the independent and combined relationship between HGS weakness and asymmetry and pain risk. We included 41,171 participants in the final analysis, with a mean follow-up period of 4.68 ± 2.61 years (50.7% female, mean age 64.3 ± 9.3 years). No nonlinear relationship was found between HGS and pain incidence (nonlinear p < 0.05 in ELSA and SHARE; >0.05 in CHARLS and HRS). After adjustment, the highest quartile groups had a significantly reduced risk of pain compared to the lowest quartile groups across all cohorts, with hazard ratios of 0.81 (0.74, 0.89) in CHARLS, 0.86 (0.77, 0.97) in HRS, 0.88 (0.77, 0.98) in ELSA, and 0.78 (0.73, 0.84) in SHARE. Participants with normal HGS had approximately 20% lower risk of pain compared to those with weak HGS. Each 5 kg increase in HGS was associated with decreased hazard ratios for pain: 0.95 (0.93, 0.97) in CHARLS, 0.97 (0.94, 0.99) in HRS, 0.96 (0.94, 0.99) in ELSA, and 0.94 (0.92, 0.95) in SHARE. The association between HGS asymmetry and pain risk was significant only in a few cohorts (HRS at 10%, 1.10 (1.03, 1.18); SHARE at 30%, 1.12 (1.05, 1.21)). No interaction effect between HGS weakness and asymmetry on pain risk was observed (all p-values for interaction >0.05). Our findings suggest that HGS can be used as an independent predictor of pain in middle-aged and older European, American, and Chinese populations. However, our results do not support the use of HGS asymmetry as an independent predictor of pain risk. It is necessary to establish appropriate criteria for HGS asymmetry across different populations. The use of both weak HGS and asymmetry as predictors of health outcomes requires further validation in more diverse populations.

Handgrip Strength Asymmetry Is Associated With Health-Related Quality Of Life Among Canadian Adults

Handgrip Strength Asymmetry Is Associated With Health-Related Quality Of Life Among Canadian Adults

A hand-in-hand phenomenon in older adults: Increased risk of frailty in geriatric outpatients associated with handgrip strength asymmetry and weakness

ObjectivesHandgrip strength (HGS) is accepted as a predictor of overall health status and a biomarker of aging, besides negative health outcomes and mortality. While differences in HGS between the dominant and non-dominant hands are expected, substantial discrepancies may signal impaired muscle function. This study aims to investigate whether handgrip asymmetry can serve as a reliable indicator of frailty in a diverse population of older adults. DesignCross-sectional study Setting and participantsA total of 512 patients aged 65 years and older who were admitted to the geriatric medicine outpatient clinic of a university hospital were enrolled in the study. MethodsThe Clinical Frailty Scale (CFS) was used to assess the overall level of frailty of the study population. The highest recorded HGS values from the non-dominant and dominant hand were used to calculate the HGS ratio. Those with a HGS ratio of dominant and non-dominant hand <0.90 or >1.10 were defined as HGS asymmetry. ResultsOf the whole study group, 61.1% was female and the mean age was 73.2 ± 6.1 years. The ratio of the participants living with frailty was 57.6% (n=219). The number of patients with HGS asymmetry was 264 (51.6%), and 48.4% (n=248) of the study population had symmetric HGS. The normal and symmetric HGS was found in 40.2% of the non-frail group, whereas it was 23.7% in patients living with frailty. Furthermore, the ratio of low and asymmetric HGS was 16.3% in the non-frail group, and 35.0% in the patients living with frailty (p<0.001). The presence of asymmetric and low HGS increased the risk of frailty three times independently of other confounding factors (OR:3.08; 95% CI:1.48-6.43; p=0.003). Conclusions and ImplicationsIdentifying HGS asymmetry along with low HGS as potential indicators of frailty may provide clinicians with a clear and quantifiable criterion for assessing older patients.

Association of handgrip strength with health care utilisation among older adults: A longitudinal study in China.

Evidence on the association between handgrip strength (HGS) and health care utilisation among Chinese older adults is scarce. In this study, we aimed to investigate the association of HGS with health care utilisation and to identify whether these associations varied by gender. The analytic sample of this prospective cohort study included 6007 Chinese older adults (≥60 years) from 2011 to 2018 waves of the China Health and Retirement Longitudinal Study. A handgrip dynamometer was used to measure HGS. We measured health care utilisation by outpatient visits, inpatient visits, and unmet hospitalisation needs. We used covariates-adjusted general estimating equations for the analyses. Longitudinal results showed that participants with weakness increased the likelihood of outpatient visits (odds ratio (OR) = 1.13; 95% confidence interval (CI) = 1.01-1.27), inpatient visits (OR = 1.51; 95% CI = 1.32-1.73), and unmet hospitalisation needs (OR = 1.44; 95% CI = 1.19-1.79) than their counterparts. Participants with weakness increased the number of outpatient visits (incidence rate ratio (IRR) = 1.29; 95% CI = 1.11-1.51) and the number of inpatient visits (IRR = 1.39; 95% CI = 1.10-1.61). Participants with HGS asymmetry increased the likelihood of unmet hospitalisation needs (OR = 1.19; 95% CI = 1.03-1.43) than their counterparts. The results of the impact of every one-kilogramme (kg) increase in HGS on health care utilisation indicated consistent results. The associations were similarly observed irrespective of gender. Chinese older adults with weakness or HGS asymmetry used more health care. Interventions for improving muscle strength and correcting strength asymmetry are highly recommended, with the potential to considerably save households and health care systems.

Relationship of Handgrip Strength and Asymmetry with Walking Ability in Older Adults with Excess Adiposity.

When low muscle mass and impaired strength and physical function coexist with excess adiposity, it is termed sarcopenic obesity (SO). Handgrip strength (HGS) is a predictor of disability and mortality. Asymmetry in HGS, particularly ≥ 10% strength differences between hands, may indicate neuromuscular dysfunction observable prior to declines in maximal strength are detectedand therefore could be incorporated to identify those at risk of physical limitations and SO. This study compares HGS values and asymmetry in older adults with excess adiposity and evaluates their relationships with physical function. Baseline data from two previous pilot weight loss studies in 85 older adults with body mass index values ≥ 30kgm-2 are included with measures of body composition, walking speed, and chair stand ability. Sixty-three participants met the criteria for SO. HGS correlated to gait speed (r = 0.22), distance walked (r = 0.40), chair stand time for 5 repetitions (r = 0.42) and during 30 s (r = 0.31). HGS asymmetry is only correlated to gait speed (r = 0.31) and there are no differences in physical function between those with and without asymmetry. Maximal HGS tests should continue to be used to screen for functional decline and disability.

The relationship between asymmetrical grip strength criteria and fall incidence among middle-aged and older Chinese adults.

Current handgrip strength (HGS) protocols employ a variety of criteria, affecting the assessment of asymmetric HGS. The impact of these different criteria on fall prediction is understudied. This study was devised to compare the relative performance of average and maximum HGS asymmetry criteria as tools to predict fall incidence among middle-aged or older adults in China. 9627 Chinese adults 50 + years of age who were participants in the China Health and Retirement Longitudinal Study (2013-2015 waves) were evaluated. The measurement of HGS was achieved based on either the maximum recorded value (HGSmax) or the average (HGSave), and these values were employed for the calculation of HGS asymmetry. Fall incidence over a 2-year period was evaluated based on self-reported data. Logistic regression analyses were utilized to determine the predictive performance of HGSmax asymmetry or HGSave asymmetry when gaging 2-year fall risk. Significant differences in overall rates of HGS asymmetry and the rates of subdivisions thereof were observed when comparing the HGSmax and HGSave criteria, with moderate consistency (kappa = 0.599, p < 0.001). Over the 2-year follow-up period, 1743 fall incidents were recorded. Adjusted logistic regression models indicated that only HGSmax asymmetry > 30.0% was significantly related to fall risk (p = 0.034, odds ratio = 1.36, 95% confidence interval: 1.02-1.81). These findings highlight the importance of HGS criteria in detecting HGS asymmetry, and suggest that HGSmax is a more robust criterion for predicting fall risk among Chinese adults 50 + years of age.

Association of handgrip strength asymmetry and weakness with cognitive function: a nationally representative cohort study

ObjectiveTo describe the association of handgrip strength asymmetry and weakness with cognitive function among Chinese middle-aged and older adults. Study designWe used data from four waves (2011, 2013, 2015, and 2018) of the China Health and Retirement Longitudinal Study. Handgrip strength was measured at baseline. Handgrip strength asymmetry was defined on the basis of the ratio of handgrip strength of the non-dominant hand to that of the dominant hand (i.e. non-dominant/dominant): a ratio of <0.9 defined as dominant handgrip strength asymmetry and >1.1 as non-dominant handgrip strength asymmetry. Weakness was defined as a handgrip strength of <28 kg for males or <18 kg for females. Main outcome measuresCognitive function with its two core dimensions (episodic memory and mental status) at each wave was assessed and standardized. Results9333 participants (48.3 % female, age 58.2 ± 9.0 years) were included. Non-dominant but not dominant handgrip strength asymmetry was significantly associated with poorer cognitive function at baseline (β = −0.121, −0.092, and −0.132 for mental status, episodic memory, and global cognition, respectively). In longitudinal analyses over 2 years, dominant handgrip strength asymmetry significantly slowed cognitive decline (β = −0.078 and −0.069 for mental status and global cognition, respectively), and non-dominant handgrip strength asymmetry accelerated cognitive decline (β = 0.053 and 0.043 for episodic memory and global cognition, respectively). Weakness was associated with poorer cognitive function at baseline and cognitive decline over 2, 4, and 7 years (all P < 0.05). ConclusionsIn middle-aged and older adults, non-dominant handgrip strength asymmetry and weakness were associated with poorer cognitive function and predicted accelerated cognitive decline. Dominant handgrip strength asymmetry may be beneficial for maintaining cognitive function.

An Indian classical dance form, Kathak in maintaining handgrip strength symmetry and reducing the risk of hypertension.

The present paper aimed to study handgrip strength (HGS) asymmetry and its association with hypertension in a sample of Kathak dancers and non-dancers of North India. Data on HGS and blood pressure were collected from 206 Kathak dancers and 235 age-matched controls, using standardized protocols. Pearson correlation coefficients assessed the association between HGS and hypertension, and binary logistic regression identified the risk of developing hypertension. HGS asymmetry was higher among non-dancers. In Kathak dancers, systolic blood pressure (SBP) was positively correlated with HGS and negatively correlated with HGS asymmetry whereas diastolic blood pressure (DBP) was negatively correlated with both HGS and HGS asymmetry. Dancers with high HGS, have significantly reduced risk of developing hypertension. Non-dancers with HGS asymmetry were 1.8 times more likely to report hypertension, relative to dancers. Kathak may be used as an alternative method for maintaining HGS symmetry and reducing the risk of developing hypertension.

Associations of Handgrip Strength Weakness and Asymmetry with Lower Cognitive Function: Results from the National Health and Nutrition Examination Survey (2011-2014).

The joint associations of handgrip strength (HGS) weakness and asymmetry with cognitive decline remain understudied in older adults. To investigate the associations between HGS weakness, asymmetry, and lower cognitive function in a nationally representative sample of older Americans. This cross-sectional study utilized data from the National Health and Nutrition Examination Survey 2011-2014. Weakness was defined as HGS <26 kg for men and <16 kg for women. Asymmetry was determined by calculating the ratio of dominant to non-dominant HGS. Participants with an HGS ratio <0.90 or >1.10 were classified as having any HGS asymmetry. Those with an HGS ratio >1.10 exhibited dominant HGS asymmetry, while those with an HGS ratio <0.90 displayed nondominant HGS asymmetry, respectively. Lower cognitive functioning was defined as global cognitive composite scores more than 1 standard deviation below the mean. Covariate-adjusted logistic regression models were used to analyze the associations between HGS asymmetry/weakness and lower cognitive functioning. Compared to individuals with non-weak and symmetric HGS, those with any HGS asymmetry alone and weakness alone had 1.017 (95% confidence interval [CI]: 0.707-1.463) and 1.391 (95% CI: 0.542-3.571) greater odds for cognitive decline, while co-occurrence of both HGS asymmetry and weakness was associated with 3.724 (95% CI: 1.711-8.107) greater odds for lower cognitive function after controlling for confounders. Individuals exhibiting both diminished and asymmetrical HGS demonstrated an elevated susceptibility to cognitive impairment, thereby implying that the inclusion of HGS asymmetry assessment in conjunction with weakness evaluation may enhance the accuracy of prognosticating cognitive decline.

The accuracy of different calculation methods when identifying handgrip strength asymmetry among middle-aged and older Chinese adults.

At present, there is no uniform standard mean of identifying handgrip strength (HGS) asymmetry based on maximum or average HGS values. Therefore, this study aimed to explore the accuracy of different calculation methods in the evaluation of HGS asymmetry. Using the maximum reading of two trials from both hands (Method A) as the reference standard, the accuracy of the HGS asymmetry identified by the average value of two trials of both hands (Method B) was determined by using various indicators, including specificity, sensitivity, the area under the receiver operating characteristic curve (AUC), positive, and negative predictive values. Overall, 12,163 individuals were included in this study, of whom 47.61% (5791/12,163) were male. The percentages of individuals with HGS asymmetry differed as a function of age and sex when using these two different methods. When employing Method A, 38.52%, 41.57%, and 44.57% of males 45 ≤ age<60, 60 ≤ age<80, and ≥ 80 years of age exhibited HGS asymmetry as compared to 40.78%, 39%, and 39.63% of females. Using Method B, the corresponding proportions were 41.69%, 42.5%, and 40% in males and 42.01%, 41.18%, and 40.55% in females, respectively. When compared to Method A, Method B was found to be effective in identifying HGS asymmetry, with AUC values ranging from 0.844 to 0.877. However, there was only moderate agreement between the two methods in assessing HGS asymmetry. Specifically, the Kappa values for the two Methods were 0.692, 0.694, and 0.766 in males aged 45 to 60, 60 to 80, and 80 years and above, respectively. For females, the Kappa values were 0.674, 0.661, and 0.751, respectively. These results demonstrated that the maximal or average HGS values from two trials using both hands has a significant impact on the consequent identification of HGS asymmetry.

Evaluation of Factors Influencing Handgrip Strength Asymmetry in Older Peruvian Adults.

Sarcopenia is a musculoskeletal disease involving the reduction of muscle mass, strength, and performance. Handgrip strength (HGS) measurements included in frailty assessments are great biomarkers of aging and are related to functional deficits. We assessed the association between potential influencing factors and HGS asymmetry in older Peruvian adults. We used a database of the Peruvian Naval Medical Center &quot;Cirujano Santiago Távara&quot; located in Callao, Peru. All the patients included were ≥60 years old and had an HGS measurement in the dominant and non-dominant hand. From a total of 1,468 patients, 74.66% had HGS asymmetry. After adjustment, calf circumference weakness (adjusted prevalence ratio [aPR]=1.08; 95% confidence interval [CI], 1.01-1.15), falls risk (aPR = 1.08; 95% CI, 1.02-1.16), and an altered Lawton index (aPR=0.92; 95% CI, 0.84-0.99) were associated with HGS asymmetry. Our findings suggest that HGS asymmetry should be measured along with other geriatric assessments used to evaluate health outcomes in the elderly to enhance health promotion and prevention aimed at preserving muscle strength to curb functional limitations in the elderly.

Association between Handgrip strength weakness and asymmetry with incident hip fracture among older Chinese adults

BackgroundTo evaluate the association between handgrip strength (HGS) weakness and asymmetry with incident hip fracture among older Chinese adults. MethodsData was obtained from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). HGS weakness was defined as maximal HGS < 28 kg in men and < 18 kg in women. HGS asymmetry was defined as the HGS ratio < 0.9 or > 1.1. Participants were categorized into normal HGS, weakness only, asymmetry only, and both weakness and asymmetry. Given the sex differences in HGS, the association between HGS weakness and asymmetry was analyzed by sex using the multivariable logistic regression models. ResultsA total of 4789 participants aged ≥ 60 years old without hip fracture at baseline were included in the final analysis. Over the four-year follow-up, there were 152 (3.17%) participants having incident hip fractures, of which 69 (2.90%) were men and 83 (3.45%) were women. Compared to the normal group, men with both weakness and asymmetry had a significantly higher risk of incident hip fracture in the fully adjusted model (adjusted odds ratio (OR): 2.31, 95% confidence interval (CI):1.17-4.52). There was no significant association between HGS asymmetry and weakness with hip fracture in women. ConclusionsOur findings indicated that among the Chinese population, men with both HGS weakness and asymmetry were associated with increased odds of hip fracture, while no significant association was observed in women.

Handgrip strength asymmetry and cognitive impairment risk: Insights from a seven-year prospective cohort study.

This study aimed to explore the links of handgrip strength and asymmetry with cognitive impairment. This was a seven-year prospective cohort study. We used data from wave 3 (2015-2017) to wave 5 (2019-2022) from the ongoing Taiwan Initiative of Geriatric Epidemiological Research (TIGER), with wave 3 as the baseline (n = 446). The study included community-dwelling participants aged 65 years or older. Handgrip strength was measured, and abnormalities were determined based on handgrip strength weakness and asymmetry. Handgrip strength asymmetry was categorized into three groups at baseline based on the handgrip strength ratio (left handgrip strength/right handgrip strength). Cognitive tests evaluating global and specific cognitive domains were conducted at baseline and two biennial follow-ups. Generalized linear mixed models were utilized to assess the associations of abnormal handgrip strength with global cognition and multiple cognitive domain progression over time. This study included 392 dementia-free participants, with an average age of 75.8 years and 179 (45.7%) males. Mild handgrip strength asymmetry was present in 88 participants (22.4%), while 53 (13.5%) exhibited moderate asymmetry. In men, the coexistence of low handgrip strength and handgrip strength asymmetry was linked to cognitive impairment over time. These associations were observed in global cognition (β^ = -1.76, 95% CI: -2.79 to -0.74), memory (immediate free recall: β^ = -0.67, 95% CI: -1.17 to -0.17), executive function (Trail Making Test-A: β^ = -0.54, 95% CI: -0.94 to -0.13), and attention (Digit span-forward: β^ = -1.00, 95% CI: -1.46 to -0.54). This study found that individuals with reduced handgrip strength and handgrip strength asymmetry had an increased risk of cognitive impairment across various domains. Moreover, this association appears to be more pronounced among men than women. Incorporating these simple assessments into regular clinical practice improves the allocation of limited screening resources and timely clinical interventions in older adults.

Low handgrip strength with asymmetry is associated with elevated all-cause mortality risk in older Chinese adults with abdominal obesity.

Low handgrip strength (HGS) and abdominal obesity (AO) have been reported to be linked to an increased all-cause mortality risk in older adults. However, the combined impact of AO with low HGS and/or HGS asymmetry on mortality risk remains unclear. Therefore, this study aimed to investigate the synergistic effects of AO and abnormal HGS on mortality risk among Chinese older adults. Baseline data of the China Health and Retirement Longitudinal Study in 2011, along with mortality outcomes obtained in 2018 were used for the analysis. Low HGS was identified as HGS <18 kg in women or <28 kg in men, while HGS asymmetry is defined as an HGS of either hand > 10% stronger than the other. AO was characterized by a waist circumference ≥90 cm in men and ≥85 cm in women. Logistic regression analysis was used to evaluate the relationship between AO, abnormal HGS and mortality risk. A total of 5186 subjects aged 60 years or older were enrolled, 50.6% of whom were male. The proportions of participants with only AO, only low HGS, only HGS asymmetry, low HGS with asymmetry, both AO and low HGS, both AO and asymmetric HGS, and AO with both low HGS and asymmetry were 20.0%, 6.1%, 16.6%, 8.3%, 3.2%, 13.4%, and 3.9%, respectively. Over the course of a 7-year follow-up interval, 970 of these individuals died, with 13.4%, 12.4%, 13.6%, 15.5%, 4.1%, 10.1% and 6.9% of deaths in the above groups, respectively. The adjusted logistic regression analysis model confirmed that only low HGS (OR = 1.897, 95%CI: 1.386-2.596, p<0.001), low HGS with asymmetry (OR = 1.680, 95%CI: 1.265-2.231, p<0.001), and AO combined with both low HGS and asymmetry (OR = 2.029, 95%CI: 1.381-2.981, p<0.001) were associated with a higher risk of mortality. Low HGS, with or without asymmetry, is associated with increased mortality risk in older Chinese adults without AO, and the combination of low HGS and HGS asymmetry further elevates mortality risk in those with AO.

Evaluation of Handgrip Strength Asymmetry to Assess Sarcopenia in Older Patients with Chronic Low Back Pain: A Retrospective Cross-Sectional Study

Evaluation of Handgrip Strength Asymmetry to Assess Sarcopenia in Older Patients with Chronic Low Back Pain: A Retrospective Cross-Sectional Study

Clinical Manifestations.

The incidence and prevalence of dementia continue to increase exponentially as people age. Finding a pre-clinical marker to detect dementia early is paramount in clinical practice. There are few prospective studies evaluating handgrip strength, handgrip strength asymmetry, and their combination on cognitive impairment. This study aimed to investigate the association of handgrip strength and handgrip strength asymmetry with future global and specific cognitive domain impairment. This is a seven-year prospective cohort study (Fig 1). We used data from the ongoing Taiwan Initiative of Geriatric Epidemiological Research (TIGER), wave 3 (2015-2017) to wave 5 (2019-2022), with wave 3 as the baseline (n = 446). Low handgrip strength was defined as the lowest tertile of sex-specific handgrip strength. Handgrip strength asymmetry was defined as a handgrip strength ratio <0.85 or >1.15 (i.e., a 15% difference). The cognitive assessment included global and specific cognitive domains. Generalized linear mixed models were used to assess the association of handgrip strength asymmetry and cognitive performance adjusted for age, years of education, cigarette smoking, alcohol drinking, hypertension, diabetes, hyperlipidemia, and physical activity. The mean age of participants was 75.7 years, and 55% were female. Participants with handgrip strength asymmetry were mostly female, never smokers, and more likely to have lower handgrip strength. Handgrip strength asymmetry was associated with poor global cognition [ = -2.14, 95% confidence interval (CI): -3.60, -0.68] and digit span-forward ( = -0.69, 95% CI: -1.25 to -0.14) over time in men. Low handgrip strength was associated with cognitive impairment (global cognition: = -1.13, 95% CI: -2.07 to -0.19; immediate free recall: = -0.48, 95%CI: -0.87 to -0.09; delayed free recall: = -0.45, 95% CI: -0.85 to -0.08); Trail Making Test- A: = -0.43, 95% CI: -0.75 to -0.12), and digit span-forward ( = -0.67 to 95% CI: -1.02 to -0.31) over time in men. Concomitant weakness and handgrip strength asymmetry had greater impairment in cognitive function in men. In this community-dwelling older population, those with low handgrip strength and handgrip strength asymmetry had an increased risk of cognitive impairment. This relationship seems more prominent in men than women.

Effects of measurement protocols and repetitions on handgrip strength weakness and asymmetry in patients with cancer.

The use of handgrip strength (HGS) in clinical cancer research is surging. The association between HGS and outcomes in patients with cancer varied across studies, which might be due to the different measurement protocols for HGS. We aimed to answer three questions: (1) Did the use of various protocols for HGS, along with different numbers of repetitions, lead to significant differences in maximum HGS values? (2) If yes, were these differences clinically significant? (3) Did the differences in HGS protocols and repetitions affect the identification of HGS weakness or HGS asymmetry? We continuously recruited adult patients with solid tumours. Two protocols were used to measure HGS: Method A, following the American Society of Hand Therapists guidelines, and Method B, following the National Health and Nutrition Examination Survey guidelines. To analyse HGS, we used the maximal value obtained from either two or three repetitions of the dominant hand or four or six repetitions of both hands. We included 497 patients (326 men and 171 women, median age: 58years). The maximal HGS values, measured with Method B, were significantly higher than those measured by Method A in both men and women, despite repetitions (all P<0.05). The maximum HGS values were significantly different across the repetition groups, regardless of measurement protocols and sex (all P<0.01). The protocol-induced differences in maximal HGS values might be clinically meaningful in over 60% of men and 40% of women despite repetitions. The repetition-induced difference was only clinically significant in 4.3-17.8% of men and 4.1-14.6% of women. To identify HGS weakness, using Method A (six repetitions) as the 'gold' standard, the other protocols demonstrated an overall accuracy of 0.923-0.997 in men and 0.965-1 in women. To identify HGS asymmetry, using Method A (six repetitions) as the 'gold' standard, Method B (six repetitions) demonstrated a diagnostic accuracy of 0.972 in men and 0.971 in women. Method A (four repetitions) showed a diagnostic accuracy of 0.837 in men and 0.825 in women, while Method B (four repetitions) showed a diagnostic accuracy of 0.825 in men and 0.807 in women. Both measurement protocols and repetitions significantly affect the maximal HGS values. The identification of HGS weakness is not significantly affected by either protocols or repetitions, while the identification of HGS asymmetry may be affected by different repetitions but not protocols.

Association of diet quality with hand grip strength weakness and asymmetry in a multi-ethnic Asian cohort.

Hand grip strength (HGS) is an important diagnostic tool for sarcopenia and a reliable predictor for age-related chronic diseases and mortality. Interventions in nutrition have been shown as a low-cost strategy to maintain muscular strength and mass. However, there are limited data on the effect of diet on HGS in Southeast Asian populations. This study aims to investigate the association of diet quality with HGS weakness and asymmetry in a multi-ethnic population in Singapore. This cross-sectional study used data from the Singapore Multi-Ethnic Cohort (n = 1547). Dietary data were collected using a validated semi-quantitative FFQ and summarised as the Dietary Quality Index - International (DQI-I). HGS was calculated as the maximum value of six measurements from both hands. HGS weakness and asymmetry were defined using well-recognised criteria. Multivariable linear regression and logistic regression were utilised for continuous and binary outcomes, respectively, adjusting for age, sex, ethnicity, physical activity and smoking status. It was found that the highest quartile of DQI-I was significantly associated with higher HGS (β = 1·11; 95 % CI 0·41, 1·82; Pfor trend < 0·001) and lower odds of HGS asymmetry (OR = 0·71; 95 % CI 0·53, 0·94; Pfor trend = 0·035) and both HGS weakness and asymmetry (OR = 0·50; 95 % CI 0·32, 0·76; Pfor trend = 0·004). Among the different components of DQI-I, only dietary adequacy was significantly associated with higher HGS (Pfor trend < 0·001) and lower odds for both HGS weakness and asymmetry (Pfor trend = 0·006). Our findings support that DQI-I, an indicator of overall diet quality, can be used to provide dietary guidelines for prevention and management of muscle wasting, sarcopenia and frailty.

Interlimb Asymmetry of Maximal Handgrip Strength and Wrist Circumference in Elite International Male Boxers

The purpose of the study was to examine interlimb maximal handgrip strength asymmetry and wrist circumference asymmetry in amateur boxing across three weight classes and two different stances. Materials and methods. The study sample comprised 12 (flyweight:4; bantamweight:4; featherweight:4) amateur elite international boxers of India. Both limbs were tested for maximal handgrip strength and wrist circumference. For both tests, interlimb asymmetry was calculated using the interlimb asymmetry equation validated by Bishop et al. (2018). One-way ANOVA was used to compare asymmetries in three different weight classes, and an independent samples t-test was used to compare asymmetries in two different boxing stances. Results. The average wrist circumference asymmetry in different weight classes was 2.85±1.97 for flyweight, 1.29±0.75 for bantamweight, and 2.44±1.23 for featherweight, whereas the average maximal handgrip strength asymmetry was 4.91±3.75 for flyweight, 7.69±1.89 for bantamweight, and 5.80±2.89 for featherweight. Non-significant differences in interlimb asymmetry for wrist circumference and maximal handgrip strength in three different weight classes and two different stances were obtained (p &gt; 0.05). Conclusions. The maximal handgrip strength asymmetry and wrist circumference asymmetry in elite international boxers were found to be less than 10 percent and observed non-significant differences in weight classes as well as stances indicate elite amateur international boxers to be less prone to interlimb asymmetry-related injuries and have favourable conditions for high performance.

Risk factors associated with weak and asymmetric handgrip strength in older Chinese adults.

This study sought to investigate the potential risk factors associated with weak and asymmetric handgrip strength (HGS) in older Chinese adults. A total of 2702 participants aged ≥65 years from the two waves of data (2011 and 2013) from the China Health and Retirement Longitudinal Study were analyzed. The highest recorded HGS values (Method A) or the average HGS values (Method B) for the dominant hand were used to compute the HGS asymmetry (nondominant HGS/dominant HGS out of 0.9-1.1) and HGS weakness (male <28 kg, female <18 kg). Risk factors associated with the weak and asymmetric HGS were identified by logistic regression analysis. Risk factors associated with weak and asymmetric HGS of varying severity differed between the two methods. Both methods identified age and illiteracy as risk factors for weak HGS with 10%-20% asymmetry. Method A also identified speech impediment, stroke, and sleep duration as additional risk factors. Similarly, both methods identified age, illiteracy, primary school education and below, diabetes, and stroke as risk factors for weak HGS and asymmetry over 30.1%. Method B additionally identified a history of falls as a risk factor. However, apart from age, the risk factors for weak HGS with 20.1%-30% asymmetry differed between the two methods-Method A identified kidney disease, while Method B identified illiteracy and asthma. The results revealed that risk factors associated with the abnormal HGS in older adults varied based on the methods used to define these conditions.