Handgrip Strength Measurement Research Articles

Undiagnosed Dementia Is Associated with Poor Physical Function in Older Adults.

Older adults with a cognitive impairment, including those not yet diagnosed, may have deficits in their physical function. We sought to determine the associations of cognitive impairment consistent with dementia (CICD) diagnosis status on handgrip strength, gait speed, and functional disability in older adults. The analytical sample included 8,383 adults aged ≥65-years without history of stroke, cancers, neurological conditions, or brain damage who participated in at least one-wave of the 2010-2016 waves of the Health and Retirement Study. A handgrip dynamometer measured handgrip strength. Men with handgrip strength <26 kg and women <16 kg were weak. Gait speed was timed across a 2.5-m course and those with slowness had gait speed <0.8 m/s. Participants with difficulty or an inability in completing any basic activities of daily living had a functional disability. The adapted Telephone Interview of Cognitive Status evaluated cognitive function. Persons with scores <7 had a CICD. Healthcare provider dementia-related diagnosis was self-reported. Undiagnosed CICD was defined as no reported dementia-related diagnosis but had CICD, while diagnosed CICD was classified as reporting a dementia-related diagnosis. Covariate-adjusted logistic models were used for the analyses. Persons with undiagnosed CICD had 1.37 (95% confidence interval (CI): 1.04-1.80) greater odds for weakness and 2.02 (CI: 1.39-2.94) greater odds for slow gait speed. Older adults with diagnosed CICD had 2.29 (CI: 1.32-3.97) greater odds for slowness and 1.85 (CI: 1.19-2.90) greater odds for functional disability. Screening for CICD could be recommended when defects in physical function are observed in older adults.

Characteristics of Japanese Older Adults Whose Trunk Muscle Mass Decreased during the COVID-19 Pandemic.

The coronavirus (COVID-19) pandemic significantly affected the physical and mental functions in older adults, resulting in “corona-frailty”. This 2-year prospective study characterized changes in quantitative measures and corona-frailty among a cohort of community-dwelling older women. Changes were evaluated using face-to-face interactions with 39 Japanese women (mean age: 76.1 ± 5.9) in 2019 (pre-pandemic baseline) and 2021 (follow-up during the pandemic). Quantitative measurements of handgrip strength, walking speed, calf circumference, body composition, and background factors were evaluated. Body weight and trunk muscle mass significantly decreased at follow-up. Multiple regression analysis, using change in trunk muscle mass as the dependent variable and background factors as independent variables, identified that decrease in trunk muscle mass was associated with “being robust at baseline” and answering “Yes” to the question of “Do you go out less frequently compared with last year”? The 2-year trunk muscle mass change for each baseline frailty stage showed a significant decrease only in the robust group (−8.0%). The decrease in trunk muscle mass might be related to pandemic-induced lifestyle restraint, suggesting that robust older adults who are healthy and active should take measures that focus on trunk muscles to avoid “corona-frailty”.

Trabecular bone score and phalangeal quantitative ultrasound are associated with muscle strength and fracture risk in hemodialysis patients.

There is growing interest in the relationship between chronic kidney disease (CKD) and fragility fracture risk. Bone mineral density (BMD) is a major determinant of bone strength, although its role as a predictor of fracture in advanced CKD and hemodialysis is still under debate. We aimed to further investigate surrogates of bone quality and their associations with muscle strength and fracture risk in hemodialysis. Multiple clinical risk factors for fracture and an estimated 10-year probability of fracture, BMD at lumbar spine and femur, trabecular bone score (TBS), X-ray vertebral morphometry, phalangeal bone quantitative ultrasonography (QUS), tibial pulse-echo ultrasonography (PEUS), and handgrip strength were evaluated in a setting of hemodialysis patients in treatment with acetate-free biofiltration (AFB) or bicarbonate hemodialysis. The bone ultrasound measurements, both at phalangeal and tibial sites, were significantly associated with lumbar and femoral DXA values. Handgrip strength was significantly associated with the 10-year probability of fracture (r = −0.57, p < 0.001 for major fractures and r = −0.53, p < 0.001 for hip fracture, respectively), with femur neck, total femur, and L1–L4 BMD values (r = 0.47, p = 0.04; r = 0.48, p = 0.02; r = 0.58, p = 0.007, respectively), with TBS at the lumbar spine (r = 0.71, p < 0.001) and with the phalangeal QUS measure of AD-SoS (r = 0.369, p = 0.023). In the hemodialysis group, 10 participants (24.3%) reported at least one morphometric vertebral fracture (Vfx); conversely, only six participants (15%) showed Vfx in the control group. In the hemodialysis group, participants with Vfx compared with participants without Vfx reported significantly different TBS, bone transmission time (BTT), cortical thickness, and handgrip strength (p < 0.05). At multiple regression analysis, by identifying as dependent variable the 10-year fracture risk for major fracture, after correcting for age, BMI, time since dialysis, AD-SoS, cortical bone thickness, and handgrip strength, only BTT (β = −15.21, SE = 5.91, p = 0.02) and TBS (β = −54.69, SE = 21.88, p = 0.02) turned out as independently associated with fracture risk. In conclusion, hemodialysis patients showed a higher fracture risk and lower surrogate indices of bone strength as TBS and QUS parameters. In this cohort of patients, handgrip strength measurements appeared to be a useful instrument to identify high-fracture-risk subjects.

Test-retest Reliability Of Upper Limb Muscular Strength In Breast Cancer Survivors

Upper limb muscular strength (ULMS) can be compromised by surgery in breast cancer survivors (BCS). Different physical and functional characteristics of upper limbs in BCS may interfere with strength measurements test-retest reliability. However, there is no data currently available on test-retest reliability of unilateral single or bilateral multi-joint strength measurements, such as handgrip strength (HGS) and bilateral isometric bench press test (BIBP), on the treated side of BCS when considering limb dominance. PURPOSE: To evaluate the test-retest reliability of ULMS in BCS who underwent surgery on the dominant treated side (onDS) or on the non-dominant treated side (nonDS). METHODS: Twenty-five BCS women (52.96 ± 8.77 years; 69.62 ± 14.97 kg) underwent ULMS assessments using HGS and BIBP in two days, three to seven days apart. The mean of three best attempts out of four to five were used for analyses. Test-retest reliability were analyzed using intraclass coefficient correlation (ICC) and coefficient of variation (CV). Paired samples t-tests were used to compare the results of the strength tests, test vs. retest. RESULTS: 40% of surgery was conducted in the nonDS (n=10) while 60.0% on the onDS (n=15). Test-retest reliability on onDS for the HGS and BIBP were ICC = 0.97 and CV = 2.78% and ICC = 0.87 and CV = 10.37% respectively. Test-retest reliability on nonDS for the HGS and BIBP were ICC = 0.91 and CV = 11.82% and ICC = 0.89 and CV = 7.52% respectively. Statistical difference was found between test-rest for HGS on nonDS (test = 21.47 ± 7.43 kgf, retest = 24.07 ± 5.57 kgf, p = 0.021), but not for HGS on onDS (test = 27.30 ± 4.63 kgf, retest = 27.42 ± 4.68 kgf, p = 0.754). For BIBP test, a significant difference between test-retest in the onDS (test = 97.65 ± 21.28 N, retest = 106.71 ± 27.44 N, p = 0.033), but not in the nonDS (test = 100.75 ± 22.12 N, retest = 104.65 ± 24.91 N, p = 0.435) was observed. CONCLUSIONS: Both, HGS and BIBP test are reliable measurements to assess ULMS in BCS; however, when surgery was on the nonDS, HGS may present higher within variability while when surgery was in the onDS, higher within variability was only observed for BIBP test. Further research is warranted to confirm or refute this initial study but also to identify specific factors that may have influenced the differences in HGS and BIBP measurements in the current study.

Longitudinal associations of sedentary behavior and physical activity with body composition in colorectal cancer survivors up to 2 years post treatment

PurposeWe investigated longitudinal associations of sedentary behavior, light-intensity physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) with body composition in colorectal cancer (CRC) survivors, between 6 weeks and 24 months post treatment. In addition, we explored whether body composition mediated associations of sedentary behavior and MVPA with fatigue.MethodsA prospective cohort study was conducted in 459 stage I–III CRC patients recruited at diagnosis. Measurements were performed of accelerometer-assessed sedentary time (hours/day), self-reported LPA and MVPA (hours/week), anthropometric assessment of body mass index (BMI), waist circumference and fat percentage (measures of adiposity), and muscle circumference and handgrip strength (measures of muscle mass/function) repeated at 6 weeks, and 6, 12 and 24 months post treatment. Longitudinal associations of sedentary time and physical activity with body composition were analyzed using confounder-adjusted linear mixed models. Mediation analyses were performed to explore the role of body mass index (BMI) and handgrip strength as mediators in associations of sedentary time and MVPA with fatigue.ResultsLess sedentary time and LPA were, independent of MVPA, longitudinally associated with increased handgrip strength, but not with measures of adiposity. More MVPA was associated with increased adiposity and increased handgrip strength. Higher BMI partly mediated associations between higher sedentary time and more fatigue.ConclusionWithin the first two years after CRC treatment, changes in sedentary behavior, physical activity and body composition are interrelated and associated with fatigue. Intervention studies are warranted to investigate causality.Trial registrationThe EnCoRe study is registered at trialregister.nl as NL6904 (former ID: NTR7099).

P05-14 Effects of a 12-weeks aquatic fitness program in women with osteoarthritis

BackgroundAs a major public health concern, there is a high association between aging and obesity, nutritional deficiencies and physical (in)activity. Thus, diseases related to cartilage are on the list of main concerns of the WHO, assuming the prevention of degeneration of articular cartilage as an important issue for which there are few effective solutions. It is imperative to find preventive strategies that can reduce the incidence of chronic osteoarthritis.MethodsEleven women (58.1±3.3 years-old) diagnosed with knee osteoarthritis (KOA) enrolled in tri-weekly aquatic fitness 45' sessions, for 12 weeks. Taking advantage of the physical properties of the water for increasing the load, a gradual use of the extension of the levers was defined. The warm-up focused on body alignment, joint mobility and breathing. The fundamental part was based on exercises that combine the cardiorespiratory component with the strength component, promoting a superior range of motion. At the end of each session there was a progressive decrease in load, alternating body segments. Before and after the 12 weeks they performed the Senior Fitness Test, hand-grip strength and body measures. All participants were volunteer, informed consent was obtained and all procedures were in accordance to Helsinki Declaration. Sessions were instructed by a CSCS®.ResultsSignificant and meaningful improvements were observed in lower body strength (p > 0.001; d = 1.10), lower body flexibility (p > 0.001; d = 2.88), aerobic endurance (p > 0.001; d = 0.95), dynamic balance (p > 0.001; d = 1.22) and hand grip strength (p > 0.001; d = 1.56). Significant, but moderate improvements were observed in body mass (p = 0.034; d = 0.56) and waist circumference (p = 0.041; d = 0.66).ConclusionsAquatic fitness induced extensive benefits in women conditioning, suggesting that this activity is able to promote an increase in life quality, even if KOA is diagnosed. This program aims to be a tool for implementing healthy behaviour, based on a physical exercise program to people with KOA. With a demographic trend towards an aging population, today society has dragged itself into a vicious cycle to the proven relationship between OA and obesity, and the increasing prevalence of both. To contribute to solving these problems, it is mandatory to have interdisciplinary perspectives that promote a motivating and lasting activity.

Muscle strength, but not body mass index, is associated with mortality in patients with non-alcoholic fatty liver disease.

BackgroundWhether adiposity and muscle function are associated with mortality risk in patients with non‐alcoholic fatty liver disease (NAFLD) remains unknown. We examine the independent and combined associations of body mass index (BMI) and muscle strength with overall mortality in individuals with NAFLD.MethodsWe analysed data from 7083 participants with NAFLD in the Thai National Health Examination Survey and their linked mortality. NAFLD was defined using a lipid accumulation product in participants without significant alcohol intake. Poor muscle strength was defined by handgrip strength of <28 kg for men and <18 kg for women, according to the Asian Working Group on Sarcopenia. The Cox proportional‐hazards model was constructed to estimate the adjusted hazard ratio (aHR) for overall mortality.ResultsThe mean age was 49.3 ± 13.2 years, and 69.4% of subjects were women. According to the Asian‐specific criteria, 1276 individuals (18.0%) were classified as lean NAFLD (BMI 18.5–22.9 kg/m2), 1465 (20.7%) were overweight NAFLD (BMI 23–24.9 kg/m2), and 4342 (61.3%) were obese NAFLD (BMI ≥ 25 kg/m2). Over 60 432 person‐years, 843 participants died. In Cox models adjusted for physiologic, lifestyle, and comorbid factors, individuals with lean NAFLD [aHR 1.18, 95% confidence interval (CI): 0.95–1.48; P = 0.138] and subjects with overweight NAFLD (aHR 1.28, 95% CI: 0.89–1.84; P = 0.158) had mortality risk estimates similar to their obese counterparts, whereas participants with lower handgrip strength had significantly higher mortality risk than those with higher handgrip strength in men and women. Compared with obese individuals with the highest handgrip strength, elevated mortality risk was observed among men (aHR 3.21, 95% CI: 1.35–7.62, P = 0.011) and women (aHR 2.22, 95% CI, 1.25–3.93, P = 0.009) with poor muscle strength. Among men, poor muscle strength was associated with increased risk of mortality with obese NAFLD (aHR 3.94, 95% CI, 1.38–11.3, P = 0.013), overweight NAFLD (aHR 2.93, 95% CI, 1.19–7.19, P = 0.021), and lean NAFLD (aHR 2.78, 95% CI, 0.93–8.32, P = 0.065). Among women, poor muscle strength was associated with increased mortality risk with obese NAFLD (aHR 2.25, 95% CI, 1.06–4.76, P = 0.036), overweight NAFLD (aHR 1.69, 95% CI, 0.81–3.51, P = 0.153), and lean NAFLD (aHR 2.47, 95% CI, 1.06–5.73, P = 0.037).ConclusionsIn this nationwide cohort of individuals with NAFLD, muscle strength, but not BMI, was independently associated with long‐term overall mortality. Measuring handgrip strength can be a simple, non‐invasive risk stratification approach for overall mortality in patients with NAFLD.

The efficiency of activities of daily living (ADLs) skills in late adulthood: A mediational approach

The term “Activities of Daily Living” (ADLs) refers to a set of fundamental tasks (i.e., toileting, bathing, personal care, eating, grooming, and getting dressed) considered necessary for living and being autonomous in everyday life. Although in the clinical setting ADLs efficiency is a marker to diagnose dementia, limited evidence on the mechanism implicating muscular function and cognitive alterations in ADLs skills in late adulthood exists. This study primarily intended to determine the extent to which executive functions mediate between muscular strength, as assessed through handgrip strength (HGS) measurement, and ADLs skills of older community-dwellers. A further goal was to explore the impact of gender and cognitive status on ADLs and HGS scores, using education as a covariate. Three hundred and thirty-four older participants, 199 females and 135 males (Mage = 77.5 years, SD = 5.6 years, age range = 63–93 years) completed a battery of tests assessing ADLs, HGS, and executive functions. The results showed that 34–56% of the variance in the ADLs condition was explained by HGS and executive functioning. Furthermore, cognitively healthy participants exhibited better ADLs skills, whereas cognitively impaired individuals, both males and females, exhibited poorer HGS efficiency. In conclusion, in clinical settings, the concurrent evaluation of ADLs skills, motor, and higher-order cognitive processes should be encouraged to detect individuals needing a person-tailored intervention to boost their quality of life.

Effect of resistive training on gastrointestinal cancer cachexia

Purpose: The current study was conducted to evaluate the therapeutic effect of resistive training in reducing the effect of cancer cachexia. Subjects and Methods: Thirty patients with gastrointestinal cancer cachexia participated in this study. Their ages ranged from 50-70 years. They were recruited from Al Kasr El-Ani hospital outpatient clinic to be treated in the outpatient clinic, Faculty of Physical Therapy, Cairo University and were divided randomly into two equal groups.Group (A) composed of 15 patients who received their ordinary medical treatment in addition to resistive training program 2 times per week for 8 weeks. Group (B) composed of 15 patients who received their ordinary medical treatment. Methods of assesment was measurements of Handgrip strength assessed by handgrip dynamometry, Lower body strength assessed using a 30-second sit to stand test, Lean body mass assessed by bioelectrical impedance analysis. Results: There was a significant increase in both muscle strength and lean body mass in patient who received resistive training. Conclusion: Resistive training can be considered as an effective method in decreasing severity of cancer cachexia in gastrointestinal cancer patient.

Hand grip strength and ocular associations: the Ural Eye and Medical Study

PurposeTo explore the associations between hand grip strength (HGS) and ocular parameters and diseases.DesignPopulation-based cohort study.MethodsParticipants of the Ural Eye and Medical Study, including 5899 (80.5%) out of 7328 eligible...

The Effect of a Citrus and Pomegranate Complex on Physical Fitness and Mental Well-Being in Healthy Elderly: A Randomized Placebo-Controlled Trial

ObjectivesThis study investigates whether a citrus and pomegranate complex (CPC) improves physical fitness, mental well-being, and blood biomarkers for oxidative stress and endothelial function in healthy elderly.DesignA randomized placebo-controlled cross-over trial.ParticipantsThe study included 36 healthy elderly aged 60–75 years old.Intervention and MeasurementsParticipants received four weeks of CPC supplementation and performed the handgrip strength and senior fitness test. Quality of life (QOL) was assessed and blood samples were analyzed for oxidative stress and endothelial function markers.ResultsAfter four weeks of CPC supplementation, handgrip strength significantly improved (p=0.019), compared to placebo. Moreover, the thinking, memory, learning, and concentration facets were improved (p=0.042), compared to placebo, and plasma malondialdehyde decreased, compared to placebo (p=0.033). The intervention did not affect senior fitness and the other QOL domains and blood parameters.ConclusionFour weeks of daily CPC supplementation significantly improves handgrip strength and self-evaluated measures of psychological function in healthy older adults. Further research should focus on mechanisms associated with physical performance.

Relationship Between Handgrip Strength and Laboratory Values in Adolescents With Non-Alcoholic Fatty Liver Disease

Introduction: The worldwide prevalence of non-alcoholic fatty liver disease in adolescents is increasing. Measuring handgrip strength is a simple and non-invasive method for assessing sarcopenia in adolescents. However, the association between handgrip strength and laboratory values has not yet been evaluated in a clinical setting. This study proposes an association between handgrip strength and laboratory values of adolescents with non-alcoholic fatty liver disease. Methodology: Data were obtained from 100 adolescents (76 males; 24 females; age, 10–18 years) who had been diagnosed with non-alcoholic fatty liver disease. Anthropometric values and handgrip strength were measured, and blood test parameters were evaluated. The association between HGS and each laboratory value was evaluated. Results: The handgrip strength of males and females was different between the low and high alkaline phosphatase level (275 U/L) groups. Regarding the handgrip-to-body weight ratio, there was a difference between the low and high groups based on alanine aminotransferase level < 24.1 U/L in males. Conclusion: Handgrip strength is easy to measure in schools and clinics. This is the first study to determine the usefulness of handgrip strength in Korean adolescents with non-alcoholic fatty liver disease. As more data are gathered, handgrip strength may be used to screen and manage adolescents with non-alcoholic fatty liver disease.

Handgrip strength is associated with adverse outcomes in patients hospitalized for COVID-19-associated pneumonia

Handgrip strength (HGS), a simple tool for the evaluation of muscular strength, is independently associated with negative prognosis in many diseases. It is unknown whether HGS is prognostically relevant in COVID-19. We evaluated the ability of HGS to predict clinical outcomes in people with COVID-19-related pneumonia. 118 patients (66% men, 63 ± 12 years), consecutively hospitalized to the “Santa Maria” Terni University Hospital for COVID-19-related pneumonia and respiratory failure, underwent HGS measurement (Jamar hand-dynamometer) at ward admission. HGS was normalized to weight2/3 (nHGS) The main end-point was the first occurrence of death and/or endotracheal intubation at 14 days. Twenty-two patients reached the main end-point. In the Kaplan–Meyer analysis, the Log rank test showed significant differences between subjects with lower than mean HGS normalized to weight2/3 (nHGS) (< 1.32 kg/Kg2/3) vs subjects with higher than mean nHGS. (p = 0.03). In a Cox-proportional hazard model, nHGS inversely predicted the main end-point (hazard ratio, HR = 1.99 each 0.5 kg/Kg2/3 decrease, p = 0.03), independently from age, sex, body mass index, ratio of partial pressure arterial oxygen and fraction of inspired oxygen (PaO2/FiO2 ratio), hypertension, diabetes, estimated glomerular filtration rate and history of previous cardiovascular cardiovascular disease. These two latter also showed independent association with the main end-point (HR 1.30, p = 0.03 and 3.89, p < 0.01, respectively). In conclusion, nHGS measured at hospital admission, independently and inversely predicts the risk of poor outcomes in people with COVID-19-related pneumonia. The evaluation of HGS may be useful in early stratifying the risk of adverse prognosis in COVID-19.

Grip Strength Trajectories and Cognition in English and Chilean Older Adults: A Cross-Cohort Study.

Growing evidence about the link between cognitive and physical decline suggests the early changes in physical functioning as a potential biomarker for cognitive impairment. Thus, we compared grip-strength trajectories over 12–16 years in three groups classified according to their cognitive status (two stable patterns, normal and impaired cognitive performance, and a declining pattern) in two representative UK and Chilean older adult samples. The samples consisted of 7069 UK (ELSA) and 1363 Chilean participants (ALEXANDROS). Linear Mixed models were performed. Adjustments included socio-demographics and health variables. The Declined and Impaired group had significantly lower grip-strength at baseline when compared to the Non-Impaired. In ELSA, the Declined and Impaired showed a faster decline in their grip strength compared to the Non-Impaired group but differences disappeared in the fully adjusted models. In ALEXANDROS, the differences were only found between the Declined and Non-Impaired and they were partially attenuated by covariates. Our study provides robust evidence of the association between grip strength and cognitive performance and how socio-economic factors might be key to understanding this association and their variability across countries. This has implications for future epidemiological research, as hand-grip strength measurements have the potential to be used as an indicator of cognitive performance.

Association of total lifetime breastfeeding duration with midlife handgrip strength: findings from Project Viva

BackgroundLactation has long term effects on maternal health, but the relationship between lactation and long-term handgrip strength, a marker of musculoskeletal function and healthy aging, has not been explored.ObjectiveExamine the relationship between total lifetime breastfeeding duration (BFD) and midlife handgrip strength.MethodsWe measured handgrip strength as a marker of overall strength among 631 women in the Project Viva cohort. At the same visit, women reported their BFD for each birth, and we derived total lifetime BFD. We used multivariable linear regression models to estimate associations of lifetime BFD in months with midlife handgrip strength in kilograms, adjusted for race/ethnicity, education, marital status, household income, age at first pregnancy and age at handgrip strength assessment.ResultsMean (standard deviation) age was 50.7 (5.1) years, lifetime BFD was 21.6 (19.5) months, and handgrip strength was 28.0 kg (6.0) in the dominant and 26.0 kg (5.6) in the non-dominant hand. In fully adjusted models, each 3-month increment in lifetime BFD was associated with 0.10 kg (95% CI 0.02, 0.18) higher handgrip strength for the dominant hand and 0.10 kg (95% CI 0.03, 0.18) for the nondominant hand. Results were similar in models examining mean BFD per pregnancy rather than total BFD. There was no evidence of effect modification by race/ethnicity.ConclusionsOur study suggests that there is a small beneficial effect of lifetime BFD on handgrip strength. Future studies can explore mechanisms by which BFD affects body composition and associations with other outcomes related to lean mass such as sarcopenia.

The Prevalence of Low Handgrip Strength and Its Predictors among Outpatient Older Adults in a Tertiary Care Setting: A Cross-Sectional Study.

Background: Low muscle strength is linked to several adverse health outcomes. However, there are limited data regarding its prevalence and associated factors in Thai older adults. This study aimed to fill that gap. Methods: This cross-sectional study was conducted with patients aged ≥ 60 years at the outpatient clinic of the internal medicine department of a tertiary care hospital from April 2020 to December 2021. Patient characteristics were collected, and a handgrip dynamometer was used to measure handgrip strength (HGS). Low HGS was defined according to the 2019 recommendations of the Asian Working Group for Sarcopenia. Results: In total, 198 patients were recruited. The prevalence of low HGS was 51%. Median HGS was 17.8 kg and 27.7 kg in women and men, respectively. Every age per year increase, greater number of medications of any type, and lower Montreal Cognitive Assessment (MoCA) score were independent factors associated with low HGS, with adjusted odds ratios of 1.1, 1.2, and 0.9, respectively. Conclusions: Low HGS was prevalent among older patients in this setting, indicating a high degree of possible sarcopenia. As there were some modifiable factors associated with low HGS, routine measurement, medication review, and cognitive evaluation are recommended for early diagnosis and management.

Thresholds for clinical practice that directly link handgrip strength to remaining years of life: estimates based on longitudinal observational data

ObjectiveMuscle strength is a powerful predictor of mortality that can quickly and inexpensively be assessed by measuring handgrip strength (HGS). What is missing for clinical practice, however, are empirically meaningful...

Role of handgrip strength testing in pre-anaesthetic check-up: A prospective cross-sectional study.

Frailty has been known to be associated with postoperative adverse events and longer hospital length of stay (LOS). Hand grip strength (HGS) is one of the parameters of measuring frailty. The aim of the study was to correlate preoperative handgrip strength and 30-day outcome of patients undergoing major abdominal surgery. It also aimed to evaluate the role of the standard preoperative variables like metabolic equivalents, revised cardiac risk index (RCRI), serum albumin, and serum creatinine along with their association with HGS testing in determining the postoperative outcome in surgical patients. This prospective observational study included 149 American Society of Anesthesiologists class III/IV patients presenting for major abdominal surgery. A mean of three measurements of dominant HGS using Camry hand dynamometer was measured. The patients were divided into groups: weak, normal, and strong depending on grip strength. Patients were followed for 30 days and postoperative outcome in terms of ventilatory support, admission to intensive care unit, cardiac complications, in-hospital mortality, and LOS were recorded. Observational data obtained were reported as mean value and analyzed using Student's t-test or Wilcoxon/Mann-Whitney Rank test. Associations between RCRI, serum albumin, and LOS with HGS were evaluated using logistic regression. The hospital LOS was significantly longer in patients with weak HGS (15.11 ± 11.03 days versus 10 ± 5.71 days, P = 0.001). Patients with weak HGS had significantly lower mean serum albumin levels compared to normal HGS (P = 0.0001) and a statistically significant RCRI score (P = 0.013). HGS can be used as a preoperative test in predicting hospital LOS after major surgery.

Agreement between maximum and mean handgrip strength measurements in cancer patients.

Background and aimHandgrip strength (HGS) can be used to identify probable sarcopenia, by measuring maximum strength and/or through the average of three measurements. This study analyzed the agreement between maximum and mean HGS measurements in identifying probable sarcopenia in cancer patients.MethodsAdult individuals of both sexes diagnosed with malignant neoplasm were evaluated. HGS (kg/f) was measured in both hands and nutritional status defined by the Patient-Generated Subjective Global Assessment (PG-SGA). Bland-Altman, Intraclass Correlation Coefficient (ICC), and Cronbach’s Alpha tests were applied to assess the agreement between measurements.ResultsOne hundred forty-one patients aged 60.0 ± 14.2 years were evaluated. There was a predominance of elderly (57.4%), male (53.2%), and non-white (58.2%) individuals, with tumors located in the lower gastrointestinal tract (GIT) (36.9%) and with suspected or some degree of malnutrition (61.0%). For men, the Bland-Altman test showed a mean error of 1.37 (95% CI—1.03 to 3.80) for dominant HGS (DHGS) and 1.50 (95% CI—1.60 to 4.60) for non-dominant HGS (NDHGS), while for women the values were 1.34 (95% CI—0.27 to 2.95) and 1.14 (95% CI—1.10 to 3.39), respectively. The ICC showed excellent reproducibility (> 0.90) and the Cronbach’s Alpha was satisfactory (0.99).ConclusionDespite the satisfactory agreement observed between maximum and mean HGS values, in this study, individuals of both sexes with probable sarcopenia were better identified through mean values.

Validity and reliability of handgrip dynamometry in older adults: A comparison of two widely used dynamometers.

BackgroundAmong older adults, decreased handgrip strength is associated with greater risk of frailty, and loss of physical function, mobility, lean mass, and overall muscular strength and power. Frailty is also associated with sarcopenia, for which handgrip strength measurement has been recommended for diagnostic purposes. Specific cutoff points for diagnosis have been identified, but use of different devices may affect measurement. Therefore to assess validity and reliability, we compared the two most frequently used devices, the Jamar hydraulic and Smedley spring handgrip dynamometers.MethodsSixty-seven older (76.2 ± 0.9 years) men (n = 34) and women (n = 33) completed two trials of handgrip strength measurement on sequential days (T1, T2) using both devices in random order. Intraclass correlations were used to assess test-retest reliability, and Bland-Altman analysis was used to assess validity as the level of agreement between devices.ResultsThere were significant (p < 0.001) relationships between devices at T1 (r = 0.94) and T2 (r = 0.94) and strong (p < 0.001) intraclass correlations were observed for both devices (Jamar = 0.98; Smedley = 0.96), indicating excellent reliability. However, there were significant differences between devices. Strength measured with Jamar was greater than Smedley at both T1 (27.4 ± 1.4 vs. 23.4 ± 1.1 kg, p < 0.001) and T2 (25.3 ± 1.4 vs. 21.8 ± 1.2 kg, p < 0.001). Bland-Altman analysis confirmed these differences. Subgroup analysis to evaluate the effect of gender and age indicated that in women and old-old (>75 years) participants, differences between devices were closer to zero for both measurements compared to men and young-old (65–75 years) participants.ConclusionsOur results demonstrate that despite excellent reliability, there is poor agreement between devices, indicating a lack of validity. For use as a diagnostic tool, standardization and device-specific cutoff points for handgrip dynamometry are needed.