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Clinical Interventions in Aging 2019Grip strength has been proposed as a biomarker. Supporting this proposition, evidence is provided herein that shows grip strength is largely consistent as an explanator... (Review)
Review
Grip strength has been proposed as a biomarker. Supporting this proposition, evidence is provided herein that shows grip strength is largely consistent as an explanator of concurrent overall strength, upper limb function, bone mineral density, fractures, falls, malnutrition, cognitive impairment, depression, sleep problems, diabetes, multimorbidity, and quality of life. Evidence is also provided for a predictive link between grip strength and all-cause and disease-specific mortality, future function, bone mineral density, fractures, cognition and depression, and problems associated with hospitalization. Consequently, the routine use of grip strength can be recommended as a stand-alone measurement or as a component of a small battery of measurements for identifying older adults at risk of poor health status.
Topics: Activities of Daily Living; Aged; Aged, 80 and over; Depression; Female; Geriatric Assessment; Hand Strength; Health Status; Hospitalization; Humans; Male; Multimorbidity; Physical Endurance; Quality of Life
PubMed: 31631989
DOI: 10.2147/CIA.S194543 -
International Journal of Environmental... Nov 2022Resistance training is considered to be an efficient treatment for age-related sarcopenia and can improve muscle strength and quality in patients. However, there are... (Meta-Analysis)
Meta-Analysis Review
Resistance training is considered to be an efficient treatment for age-related sarcopenia and can improve muscle strength and quality in patients. However, there are currently no recommendations on resistance training parameters to improve muscle strength and quality in elderly patients with sarcopenia. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and included 13 eligible RCTs. Resistance training significantly improved grip strength, gait speed, and skeletal muscle index in patients with age-related sarcopenia, and kettlebell was found to be the most effective modality. However, it is noteworthy that the elastic band is also a recommended form of resistance training considering that the kettlebell intervention was tested in only one study, while the elastic band was confirmed by multiple studies. Elastic band training (Hedges's g = 0.629, 95%CI = 0.090-1.168, < 0.05) (40-60 min per session, more than three times per week for at least 12 weeks) was the most efficient training method. Thus, resistance training can significantly improve muscle strength and muscle quality in elderly patients with sarcopenia. In addition, moderate-intensity resistance training using elastic bands may be the best training prescription for elderly patients with sarcopenia.
Topics: Humans; Aged; Resistance Training; Sarcopenia; Muscle Strength; Muscle, Skeletal; Hand Strength
PubMed: 36497565
DOI: 10.3390/ijerph192315491 -
Journal of Hepatology May 2022Cross-sectional studies have reported that lower muscle mass and strength are risk factors for non-alcoholic fatty liver disease (NAFLD). However, the evidence from...
BACKGROUND & AIMS
Cross-sectional studies have reported that lower muscle mass and strength are risk factors for non-alcoholic fatty liver disease (NAFLD). However, the evidence from prospective studies is limited. This study examined both the strength and pattern of the associations between these 2 physical capability markers and severe NAFLD using data from the UK Biobank study.
METHODS
A total of 333,295 participants were included in this prospective study. Grip strength was measured using a Jamar J00105 hydraulic hand dynamometer, and the Janssen equation was used to estimate skeletal muscle mass by bioelectrical impedance. Muscle mass was adjusted for body weight and all exposures were sex-standardised. Associations of muscle mass and strength with severe NAFLD (defined as hospital admission or death) were first investigated by tertile of each exposure using Cox proportional hazard models. Non-linear associations were investigated using penalised cubic splines fitted in the Cox proportional hazard models.
RESULTS
After a median follow-up of 10 years (IQR 9.3 to 10.7 years), 3,311 individuals had severe NAFLD (3,277 hospitalisations and 34 deaths). Compared with the lowest tertile of muscle mass, the risk of severe NAFLD was lower in the middle (hazard ratio 0.76; 95% CI 0.70-0.83) and the highest tertile (hazard ratio 0.46; 95% CI 0.40-0.52). Tertiles of grip strength showed a similar pattern. Non-linearity was only identified for muscle mass (p <0.001). Being on the lower tertile of grip strength and muscle mass accounted for 17.7% and 33.1% of severe NAFLD cases, respectively.
CONCLUSIONS
Lower muscle mass and grip strength were associated with higher risk of developing severe NAFLD. Interventions to improve physical capability may be protective, but this needs to be investigated in appropriately designed trials.
LAY SUMMARY
Lower muscle mass - both quantity and quality - were associated with a higher risk of severe non-alcoholic fatty liver disease. Therefore, improving muscle mass might be a protective factor against this increasing public health problem.
Topics: Biological Specimen Banks; Cross-Sectional Studies; Hand Strength; Humans; Muscle, Skeletal; Non-alcoholic Fatty Liver Disease; Prospective Studies; Sarcopenia; United Kingdom
PubMed: 35085594
DOI: 10.1016/j.jhep.2022.01.010 -
PloS One 2014Epidemiological studies have shown that weaker grip strength in later life is associated with disability, morbidity, and mortality. Grip strength is a key component of... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Epidemiological studies have shown that weaker grip strength in later life is associated with disability, morbidity, and mortality. Grip strength is a key component of the sarcopenia and frailty phenotypes and yet it is unclear how individual measurements should be interpreted. Our objective was to produce cross-sectional centile values for grip strength across the life course. A secondary objective was to examine the impact of different aspects of measurement protocol.
METHODS
We combined 60,803 observations from 49,964 participants (26,687 female) of 12 general population studies in Great Britain. We produced centile curves for ages 4 to 90 and investigated the prevalence of weak grip, defined as strength at least 2.5 SDs below the gender-specific peak mean. We carried out a series of sensitivity analyses to assess the impact of dynamometer type and measurement position (seated or standing).
RESULTS
Our results suggested three overall periods: an increase to peak in early adult life, maintenance through to midlife, and decline from midlife onwards. Males were on average stronger than females from adolescence onwards: males' peak median grip was 51 kg between ages 29 and 39, compared to 31 kg in females between ages 26 and 42. Weak grip strength, defined as strength at least 2.5 SDs below the gender-specific peak mean, increased sharply with age, reaching a prevalence of 23% in males and 27% in females by age 80. Sensitivity analyses suggested our findings were robust to differences in dynamometer type and measurement position.
CONCLUSION
This is the first study to provide normative data for grip strength across the life course. These centile values have the potential to inform the clinical assessment of grip strength which is recognised as an important part of the identification of people with sarcopenia and frailty.
Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Child; Child, Preschool; Cohort Studies; Cross-Sectional Studies; Databases, Factual; Female; Hand Strength; Humans; Male; Middle Aged; Muscle Strength Dynamometer; Prevalence; Sarcopenia; United Kingdom; White People; Young Adult
PubMed: 25474696
DOI: 10.1371/journal.pone.0113637 -
Journal of Rehabilitation Medicine Aug 2008To assess the inter-rater and intra-rater reliability and validity of the original and a modified Medical Research Council scale for testing muscle strength in radial... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To assess the inter-rater and intra-rater reliability and validity of the original and a modified Medical Research Council scale for testing muscle strength in radial palsy.
DESIGN
Prospective, randomized validation study.
PATIENTS
Thirty-one patients with peripheral paresis of radial innervated forearm muscles were included.
METHODS
Wrist extension, finger extension and grip strength were evaluated by manual muscle testing. Dynamometric measurement of grip strength was performed. Pair-wise weighted kappa coefficients were calculated to determine inter-rater and intra-rater reliability. The 2 scores were compared using the signed-rank test. Spearman's correlation coefficients of the maximal relative force measurements with the median (over-raters) Medical Research Council and modified Medical Research Council scores were calculated to determine validity.
RESULTS
Inter-rater agreement of the Medical Research Council scale (finger extension: 0.77; wrist extension: 0.78; grip strength: 0.78) and the modified Medical Research Council scale (finger extension: 0.81; wrist extension: 0.78; grip strength: 0.81) as well as intra-rater agreement of the Medical Research Council scale (finger extension: 0.86; wrist extension: 0.82; grip strength: 0.84) and the modified Medical Research Council scale (finger extension: 0.84, wrist extension: 0.81; grip strength: 0.88) showed almost perfect agreement. Spearman's correlation coefficients of the maximal relative force measurements with the median Medical Research Council and modified Medical Research Council score were both 0.78.
CONCLUSION
Medical Research Council and modified Medical Research Council scales are measurements with substantial inter-rater and intra-rater reliability in evaluating forearm muscles.
Topics: Adult; Aged; Female; Hand Strength; Humans; Male; Middle Aged; Muscle Strength; Muscle Weakness; Observer Variation; Prospective Studies; Radial Neuropathy; Reproducibility of Results
PubMed: 19020701
DOI: 10.2340/16501977-0235 -
Frontiers in Endocrinology 2022Muscle strength has been shown to exert positive effects on bone health. The causal relationship between hand grip strength and osteoporosis is an important public...
BACKGROUND
Muscle strength has been shown to exert positive effects on bone health. The causal relationship between hand grip strength and osteoporosis is an important public health issue but is not fully revealed. The goal of this study was to investigate whether and to what extent hand grip strength affects bone mineral density (BMD) and fracture risk.
METHODS
We conducted a state-of-the-art two-sample Mendelian randomization analysis. Genomewide significant (<5×10) single nucleotide polymorphisms associated with hand grip strength were obtained. Summary level data of BMD and fractures at different body sites (lumbar spine, heel, forearm and femoral neck) was obtained from a large-scale osteoporosis database. The inverse variance weighted method was the primary method used for analysis, and the weighted-median, MR-Egger were utilized for sensitivity analyses.
RESULTS
The results provided strong evidence that hand grip strength trait was causally and positively associated with lumbar spine BMD (: 0.288, 95% CI: 0.079 to 0.497; =0.007), while no causal relationship was found between hand grip strength and BMD at heel (: -0.081, 95% CI: -0.232 to 0.070; =0.295), forearm (: 0.-0.101, 95% CI: -0.451 to 0.248; =0.571) or femoral neck (: 0.054, 95% CI: -0.171 to 0.278; =0.639). In addition, no statistically significant effects were observed for hand grip strength on fracture risks (: -0.004, 95% CI: -0.019 to 0.012; =0.662).
CONCLUSIONS
This study showed a positive causal relationship between hand grip strength and lumbar BMD, which is the most common site of osteoporotic fracture, but did not find a causal relationship between hand grip strength and BMD of heel, forearm, or femoral neck. No statistically significant effect of hand grip strength on fracture risk was observed. This study indicates variations in the abilities of hand grip strength trait to causally influence BMD at different skeleton sites. These results should be considered in further studies and public health measures on osteoporosis prevention strategies.
Topics: Humans; Bone Density; Hand Strength; Mendelian Randomization Analysis; Osteoporosis; Osteoporotic Fractures; Lumbar Vertebrae; Femur Neck
PubMed: 36578964
DOI: 10.3389/fendo.2022.1020750 -
The Journal of Hand Surgery, European... Feb 2009Assessment of hand strength is used in a wide range of clinical settings especially during treatment of diseases affecting the function of the hand. This investigation...
Assessment of hand strength is used in a wide range of clinical settings especially during treatment of diseases affecting the function of the hand. This investigation aimed to determine age- and gender-specific reference values for grip and pinch strength in a normal Swiss population with special regard to old and very old subjects as well as to different levels of occupational demand. Hand strength data were collected using a Jamar dynamometer and a pinch gauge with standard testing position, protocol and instructions. Analysis of the data from 1023 tested subjects between 18 and 96 years revealed a curvilinear relationship of grip and pinch strength to age, a correlation to height, weight and significant differences between occupational groups. Hand strength values differed significantly from those of other populations, confirming the thesis that applying normative data internationally is questionable. Age- and gender-specific reference values for grip and pinch strength are presented.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Aging; Female; Functional Laterality; Hand Strength; Humans; Male; Middle Aged; Muscle Strength Dynamometer; Pinch Strength; Reference Values; Sex Factors; Switzerland; Young Adult
PubMed: 19129352
DOI: 10.1177/1753193408096763 -
Arthritis Research & Therapy Nov 2018Evidence for non-pharmacological interventions in hand osteoarthritis is promising but still scarce. Combined interventions are most likely to best cover the clinical... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Evidence for non-pharmacological interventions in hand osteoarthritis is promising but still scarce. Combined interventions are most likely to best cover the clinical needs of patients with hand osteoarthritis (OA). The aim of this study was to evaluate the effect of a combined, interdisciplinary intervention feasible in both primary and specialist care compared to routine care plus placebo in patients with hand OA.
METHODS
This was a randomised, controlled 2-month trial with a blinded assessor. In the combined-intervention group, rheumatology-trained health professionals from different disciplines delivered a one-session individual intervention with detailed information on functioning, activities of daily living, physical activity, nutrition, assistive devices, instructions on pain management and exercises. Telephone follow up was performed after 4 weeks. The primary outcome was grip strength after 8 weeks. Secondary outcomes were self-reported pain, satisfaction with treatment, health status, two of the Jebsen-Taylor Hand Function subtests and the total score of the Australian/Canadian Hand Osteoarthritis Index (AUSCAN). Statistical significance was calculated by Student's t test or the Mann-Whitney U test depending on data distribution. Binominal logistic regression models were fitted, with the primary outcome being the dependent and the group allocation being the independent variable.
RESULTS
There were 151 participating patients (74 in the combined-intervention and 77 in the routine-care-plus-placebo group) with 2-month follow-up attendance of 84% (n = 128). Grip strength significantly increased in the combined-intervention group and decreased in the routine-care group (dominant hand, mean 0.03 bar (SD 0.11) versus - 0.03 (SD 0.13), p value = 0.001, baseline corrected values) after 8 weeks.
CONCLUSION
The combined one-session individual intervention significantly improved grip strength and self-reported satisfaction with treatment in patients with hand OA. It can be delivered by different rheumatology-trained health professionals and is thus also feasible in primary care.
TRIAL REGISTRATION
ISRCTN registry, ISRCTN62513257 . Registered on 17 May 2012.
Topics: Aged; Exercise Therapy; Female; Hand; Hand Strength; Humans; Male; Middle Aged; Osteoarthritis; Pain Measurement; Referral and Consultation; Self Report; Single-Blind Method
PubMed: 30413191
DOI: 10.1186/s13075-018-1747-0 -
Aging Clinical and Experimental Research Aug 2017Hand function is critical for independence in activities of daily living for older adults.
BACKGROUND
Hand function is critical for independence in activities of daily living for older adults.
AIMS
The purpose of this study was to examine how grip strength, arm curl strength, and manual dexterous coordination contributed to time-based versus self-report assessment of hand function in community-dwelling older adults.
METHODS
Adults aged ≥60 years without low vision or neurological disorders were recruited. Purdue Pegboard Test, Jamar hand dynamometer, 30-second arm curl test, Jebsen-Taylor Hand Function Test, and the Late-Life Function and Disability Instrument were administered to assess manual dexterous coordination, grip strength, arm curl strength, time-based hand function, and self-report of hand function, respectively.
RESULTS
Eighty-four adults (mean age = 72 years) completed the study. Hierarchical multiple regressions show that older adults with better arm curl strength (β = -.25, p < .01) and manual dexterous coordination (β = -.52, p < .01) performed better on the time-based hand function test. In comparison, older adults with better grip strength (β = .40, p < .01), arm curl strength (β = .23, p < .05), and manual dexterous coordination (β = .23, p < .05) were associated with better self-report of upper extremity function.
CONCLUSIONS
The relationship between grip strength and hand function may be test-specific. Grip strength becomes a significant factor when the test requires grip strength to successfully complete the test tasks. Arm curl strength independently contributed to hand function in both time-based and self-report assessments, indicating that strength of extrinsic muscles of the hand are essential for hand function.
Topics: Activities of Daily Living; Aged; Arm; Cross-Sectional Studies; Female; Geriatric Assessment; Hand Strength; Humans; Male; Muscle, Skeletal; Self Report
PubMed: 27577988
DOI: 10.1007/s40520-016-0628-0 -
European Heart Journal Jan 2017It is unclear whether the potential benefits of physical activity differ according to level of cardiorespiratory fitness (CRF) or strength. The aim of this study was to... (Observational Study)
Observational Study
The association between physical activity and risk of mortality is modulated by grip strength and cardiorespiratory fitness: evidence from 498 135 UK-Biobank participants.
AIMS
It is unclear whether the potential benefits of physical activity differ according to level of cardiorespiratory fitness (CRF) or strength. The aim of this study was to determine whether the association between physical activity and mortality is moderated by CRF and grip strength sufficiently to inform health promotion strategies.
METHODS AND RESULTS
498 135 participants (54.7% women) from the UK Biobank were included (CRF data available in 67 702 participants). Exposure variables were grip strength, CRF, and physical activity. All-cause mortality and cardiovascular disease (CVD) events were the outcomes. 8591 died over median 4.9 years [IQR 4.3–5.5] follow-up. There was a significant interaction between total physical activity and grip strength (P < 0.0001) whereby the higher hazard of mortality associated with lower physical activity was greatest among participants in the lowest tertile for grip strength (hazard ratio, HR:1.11 [95% CI 1.09–1.14]) and lowest among those in the highest grip strength tertile (HR:1.04 [1.01–1.08]). The interaction with CRF did not reach statistical significance but the pattern was similar. The association between physical activity and mortality was larger among those in the lowest tertile of CRF (HR:1.13 [1.02–1.26]) than those in the highest (HR:1.03 [0.91–1.16]). The pattern for CVD events was similar.
CONCLUSIONS
These data provide novel evidence that strength, and possibly CRF, moderate the association between physical activity and mortality. The association between physical activity and mortality is strongest in those with the lowest strength (which is easily measured), and the lowest CRF, suggesting that these sub-groups could benefit most from interventions to increase physical activity.
Topics: Adult; Aged; Biological Specimen Banks; Cardiorespiratory Fitness; Cardiovascular Diseases; Exercise; Female; Hand Strength; Humans; Male; Middle Aged; Physical Fitness; Risk Factors
PubMed: 28158566
DOI: 10.1093/eurheartj/ehw249