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Grip and pinch strength in Chinese adults and their relationship with anthropometric factors.

In this study, we evaluated the correlation of four types of hand strength (hand grip, tip pinch, palmar pinch and key pinch) with age, sex, body weight, body height, body mass index, triceps skinfold thickness, mid-arm circumference and mid-forearm circumference in a group of 437 Chinese adults (195 men and 242 women) who ranged in age from 28 to 78 years. All of the hand strengths studied correlated positively with gender, body weight, body height, mid-arm and mid-forearm circumference and negatively with age and triceps skinfold thickness in the analyses of simple correlation coefficients. Men were found to be more powerful than women in all hand strength types in different age groups. The magnitude of strength decline with age was more prominent in grip strength than pinch strength including palmar, tip and key. Stepwise multiple regression analyses showed that sex, age and mid-forearm circumference were most predictive of all types of hand strength. Body height was an additional independent predictor of grip and palmar pinch. Body mass index, body weight, mid-arm circumference and triceps skinfold thickness were not independent predictors associated with hand strength.

Adult↗

Alteration of period and amplitude of circadian rhythms in shift workers. With special reference to temperature, right and left hand grip strength.

48 male shift workers in various industries volunteered to document circadian rhythms in sleeping and working, oral temperature, grip strength of both hands, peak expiratory flow and heart rate. All physiological variables were self-measured 4 to 5 times a day for 2 to 4 weeks. Individual time series were analyzed according to several statistical methods (power spectrum, cosinor, chi squares, ANOVA, correlation, etc.) in order to estimate rhythm parameters such as circadian period (tau) and amplitude (A), and to evaluate subgroup differences with regard to tolerance to shift work, age, duration of shift work, speed of rotation and type of industry. The present study confirms for oral temperature and extends to other variables (grip strength of both hands, heart rate) that intolerance to shift work is frequently associated with both internal desynchronization and small circadian amplitude. The internal desynchronization among several circadian rhythms supports the hypothesis that these latter are driven by several oscillators. Many differences were observed between circadian rhythms in right and left hand grip strength: circadian tau in oral temperature was correlated with that in the grip strength of the dominant hand but not with that of the other hand; changes in tau s of the non-dominant hand were age-related but did not correlate with temperature tau; only the circadian A of the non-dominant hand was associated with a desynchronization. Thus, circadian rhythms in oral temperature and dominant hand grip strength may be driven by the same oscillator while that of the non-dominant hand may be governed by a different one. Internal desynchronization between both hand grip rhythms as well as desynchronization of performance rhythms reported by others provide indirect evidence that circadian oscillator(s) may be located in the human cerebral cortex.

Adult↗

The effect of hand osteoarthritis on grip and pinch strength and hand function in postmenopausal women.

The aim of the study was to investigate the effect of osteoarthritis on hand function in postmenopausal women. One hundred patients with hand OA and 70 healthy volunteers as controls were evaluated. Grip and pinch strength measurements and Dreiser's functional index were used for hand function. Pain was assessed by a visual analog scale, and tenderness was assessed by palpation and scored, depending on the severity of tenderness, as 0, 1 or 2. Heberden's and Bouchard's nodules and joint involvement were also recorded. The number of patients with only distal interphalangeal joint involvement was 50 (50%), those with distal interphalangeal joint plus proximal interphalangeal joint involvement was 49 (49%), and those with carpometacarpal joint involvement numbered 18 (18%). The incidence of Heberden's and Bouchard's nodules was 85% and 36%, respectively. Eighty-six (86%) patients were suffering from pain and 57 were found to have tenderness. Grip and pinch strength was significantly lower (p<0.05) and Dreiser's functional index score was significantly higher (p<0.001) in the study group (particularly in grade 4 OA). Grip strength was lower in hand OA patients with distal interphalangeal joint plus proximal interphalangeal joint involvement than in those with only distal interphalangeal joint and carpometacarpal joint involvement. Pinch strength was also lower in patients with distal interphalangeal joint plus proximal interphalangeal joint plus carpometacarpal joint involvement. The patients with Heberden's and Bouchard's nodules had lower grip and pinch strength than controls. Also, pain and tenderness had significant (p<0.05) effects on hand function. Dreiser's total score ranged from 0 to 10 in 80 (80%) patients and from 11 to 20 in 20 patients. In conclusion, hand osteoarthritis contributes to hand dysfunction, mainly related to the severity of osteoarthritis, pain, joint involvement and the presence of nodules.

Aged↗

Dynamometer measurements of hand-grip strength predict multiple outcomes.

Hand-grip strength, which can be measured easily and objectively using a dynamometer, is predictive of multiple outcomes among a variety of subjects. Although the literature is not fully consistent, it tends to support grip strength as a predictor of postoperative complications, mortality, and functional decline. Hand-grip dynamometry may merit broader application as a screening procedure.

Chronic Disease↗

Placebo effect on the circadian rhythm period tau of temperature and hand-grip strength rhythms: interindividual and gender-related difference.

Two different medications, one assumed to be a tranquilizer and the other an antifatigue agent, were tested. Both were found to be ineffective and thus were viewed as placebos and named P1 and P2. The effect of P1 and P2 on the circadian rhythms of a set of variables (e.g., sleep/wake, oral temperature and grip strength of both hands) were monitored by five to 10 measurements per day over three consecutive 8- to 10-day spans. The first documented span was a control (no medication), and the second and third spans (in randomized order) were under P1 and P2. Healthy subjects volunteered for the studies: nine men and seven women (median age 28 years) in study 1 and 12 men and 12 women (median age 36 years) in study 2. They were synchronized with diurnal activity from 07:00 h (+/- 30 min) to 00:00 h (+/- 1 h) and nocturnal rest. De Prins' method was used to obtain the prominent period tau in each (control, P1, and P2) individual time series. The chi 2 test was used to test group and subgroup differences. All 40 subjects exhibited a significant sleep/wake rhythm with a tau = 24 h in control, P1, and P2 series. During the control span a gender-related statistically significant difference was observed: fewer men than women exhibited a temperature rhythm desynchronized from 24 h. In addition, more women than men had a tau < 24 h during control. The gender-related difference was obliterated by placebos. Similarly desynchronized circadian rhythms of left and right hand-grip strength were observed in both men and women during the control span, which were all obliterated by placebo but only in men. Results are discussed with regard to a genetic model of human dyschronism as proposed by the authors.

Adult↗

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↗

Finger flexion force and hand grip strength after tendon repair.

Isolated finger flexion force and hand grip strength were measured in a group of patients with flexor tendon lacerations treated by primary tendon repair. The results show that reduced isolated finger flexion force is much more common than reduced hand grip strength (66% and 26% respectively). Reduced finger flexion force is strongly correlated to elongation in tendon repair, to the range of motion in the distal interphalangeal joint, and to reduced hand grip strength in patients with lesions of both flexor tendons in one finger. Range of motion in the distal interphalangeal joint and hand grip strength in the individual patient are of little value for prediction of isolated finger flexion force, however. Hand grip strength is sufficient for evaluation of strength in many cases, but knowledge of finger flexion force is a valuable adjunct in analyzing patients with subjective and/or objective weakness in their hands after flexor tendon surgery.

Adolescent↗

Relationship between grip strength and hand bone mineral density in healthy adults.

The aim of this study was to assess site-specific relationship of hand bone mineral density (BMD) with hand size, pinch and grip strength in healthy people aged 19-50 years. A total of 143 healthy volunteers participated in the study (mean age: 34 years). One hundred-six were premenopausal women (mean age: 34 years) and 37 were men (mean age: 34 years). Grip and pinch strength was measured by a Jamar dynamometer (Jamar, Irvington, NY). Second, third and fourth middle phalanx BMD were measured on a MetriScan densitometer (Hayward, CA) and mean value of these three phalanxes were used in the analysis. There was not a significant correlation between hand BMD and grip, pinch strength or hand size in premenopausal women. A significant correlation between hand BMD and grip strength was found in men (right hand; r=0.44, p=0.007, left hand; r=0.33, p=0.05). Hand size was not correlated with hand BMD both in men and in women. The short-term precision for RA was estimated as 0.44%. This is the first report of a site-specific relationship of BMD measured by radiographic absorptiometry with hand size, pinch and grip strength in healthy men and premenopausal women. Our results revealed that there is a moderate correlation between hand-grip strength and hand BMD in men. Hand size does not predict hand BMD both in men and women. Radiographic absorptiometry is a practical and reproducible method to detect bone mineral density of hands and may be a valuable screening tool for osteoporosis.

Adult↗

Hand grip strength in the adult Malaysian population.

PURPOSE: To measure the hand grip strength of Malaysians aged 18 to 65 years. METHODS: Between January and April 2003, 412 subjects (200 women and 212 men) were recruited from staff, students, and visitors of the University of Malaya Medical Centre. Socioeconomic, general health, and lifestyle data were collected from each subject using a standard questionnaire. Weight and height were measured prior to testing. Standardised positioning and instructions based on several hand grip protocols were used. Data were collected using the LIDO kinetic work set. RESULTS: 93% of the subjects were right-hand dominant and 7% were left-hand dominant. Hand grip strength was significantly correlated with hand dominance, gender, occupation, height, and weight, but not body mass index. No significant differences in grip strength were noted with regard to race or level of income. Men were stronger than women in all age-groups, with a ratio of 1.75:1. In both right- and left-hand dominant groups, the dominant hand was consistently stronger than the non-dominant side, with a ratio of 1.12:1 in the right-hand dominant group and 1.05:1 in the left-hand dominant group. The strongest hand grip strength in the right-hand dominant group occurred in the age-group of 25 to 34 years; in the left-hand dominant group it was in the age-group of 18 to 24 years. In western populations, the mean grip strength can be as much as 1.5 times greater than in the Malaysian population. CONCLUSION: Data derived from western populations cannot be applied to a comparable Malaysian population. Gender, hand dominance, age, occupation, weight, and height must be considered when establishing normal values for grip strength.

Adolescent↗

Omnidirectional assessment of one-handed manual strength at three handle heights.

Maximal right-handed omnidirectional strengths of eleven males were measured at three handle heights of 1.5 m, 1.0 m and 0.5 m using the Tri-Axial Force measurement System. The postures of the subjects were constrained by preventing rotation of the footbase in order to ensure that the forward-backward and leftward-rightward axes of the subject remained constant relative to the measurement system. A two-way repeated measures analysis of variance revealed highly significant differences in maximal strengths between the three heights and the 614 directions of exertion measured. A highly significant interaction was found between height and direction. At all three hand heights a restricted area of great strength was found in the direction of upward and almost directly forward from the subject. A second, less powerful, but more widespread area of high strength was also found at each height. At the 1.5-m height the peak was in the backward and almost vertically downward area. At the 1.0-m height the peak was in the area of slightly downward and largely backward. At the 0.5-m height the peak was to the right of upward and backward. RELEVANCE: Very few real-life manual exertions involve forces which are purely in the sagittal, forward-backward plane, with lateral components of force usually being involved as well. The data presented extend the knowledge base about male one-handed strengths.

Journal Article↗

Hand-grip strength predicts incident disability in non-disabled older men.

OBJECTIVES: To verify if hand-grip performance in older men is a predictor of disability. DESIGN: Population-based prospective study. SETTING: A sample from the Italian rural cohorts of the FINE study (Finland, Italy, Netherlands Elderly), representative of the general population of elderly men surveyed in 1991 and 1995. PARTICIPANTS: 140 men aged 71-91 years who reported no disability in performing activities of daily living (ADLs), instrumental activity of daily living (IADLs) and mobility activities at baseline examination and provided information on their functional status at follow-up 4 years later. MEASUREMENTS: Disability was defined as needing help in performing ADLs, IADLs and mobility. Hand-grip strength was evaluated at baseline by a mechanical dynamometer. RESULTS: After adjusting for potential confounding variables, a lower concentration of high-density lipoprotein cholesterol was the only factor predicting disability in men aged 76 years or younger and only reduced hand-grip strength predicted incident disability in men 77 years or older. CONCLUSION: Poor hand strength as measured by hand-grip is a predictor of disability in older people. The hand-grip test is an easy and inexpensive screening tool to identify elderly people at risk of disability.

Activities of Daily Living↗

Digit ratio and hand-grip strength in German and Mizos men: cross-cultural evidence for an organizing effect of prenatal testosterone on strength.

The ratio of the length of the second and fourth digits (2D:4D), a putative proxy of prenatal testosterone (PT), is correlated with measures of physical fitness. The relationship between the organizing effect of PT on physical fitness is likely to arise as a response to intrasexual male competition for females. Physical strength is also likely to be important in intrasexual conflict, but nothing is known concerning the relationship between 2D:4D and strength. The strength of an individual is strongly influenced by body size, and 2D:4D is strongly dependent on ethnicity. We present evidence that strength, as measured from hand-grip strength, is related to 2D:4D in samples from two ethnic groups (52 Caucasian men from Germany, and 88 Oriental Mizos men from northeast India) which differed markedly in size. We found that 1) the German men were heavier and stronger, but had higher 2D:4D (lower PT) than the Mizos men; 2) a median split for grip strength into low (LGS) and high (HGS) groups showed that for right-hand 2D:4D (but not left-hand 2D:4D), the LGS men had higher 2D:4D than the HGS men; and 3) the relationships between right 2D:4D and grip strength were independent of ethnicity, age, height, and weight. Measures of grip strength correlate strongly with strength in other muscle groups, so we conclude that PT may have an early organizing effect on strength in men, and this is likely to be widespread in human groups.

Adult↗

The impact of gender, body dimension and body composition on hand-grip strength in healthy children.

Maximum hand-grip (HG) strength, body composition and main anthropometric variables were evaluated in 278 children with normal weight and growth, aged 5-15 yr divided into 3 age groups: group 1, age+/-SD: 7.6+/-0.9 yr 7.6+/-0.9 SD (Tanner stage 1); group 2, age: 10.8+/-0.7 yr (Tanner stage: 2-3); group 3, age: 13.2+/-0.9 yr (Tanner stage: 4-5). Weight, height, body surface area (BSA), BMI, percent body fat (BF) and fat free mass (FFM) increased progressively and significantly from the younger to the older age group. A significant difference between genders was detected only for BF and FFM, females having a higher fat mass and a lower FFM compared to males. Most children were right-handed (91%). In either genders, a curvilinear relation was detected between HG strength and age, with best fit for the dominant (d) hand given by the equations: dHG=5.891 *10(0.051) age, r2=0.986, p<0.001 in males and dHG=6.163 *10(0.045) age r2=0.973, p<0.001 in females. The increase in HG strength after 11 yr appears to be steeper in males as compared with that found in females. In both d and non-dominant (nd) hand, a significant difference in HG strength was detected between males and females, the average difference being about 10% at all ages. For both genders, nd hand was significantly weaker than d hand in the older age groups (2 and 3), but not in the younger group 1. Age and gender-dependent differences in HG strength (but not differences between d and nd hand) disappear if HG strength is normalized for FFM. Thus, in general, dHG strength normalized for FFM resulted on average to be 0.67+/-0.11 kg/kg. A multiple linear regression analysis indicated that HG was positively correlated with BMI, BSA, stature, stature2 and FFM (p<0.001 for all correlations) without differences between genders, while a negative correlation was found between HG strength and %BF. The most significant correlation was found between HG strength and FFM, without any significant difference between genders, so that the overall equation describing the line for the d hand was: dHG strength= 2.32+0.63 FFM, r2=0.72, p<0.001. In conclusion, the present study indicates that the age-dependent increase of HG strength as well as the between-gender differences are strongly related to changes of FFM values occurring during childhood. Moreover, the study provides a standard normative value of maximal HG strength for the healthy children population in Northern Italy.

Adolescent↗

Hand grip strength--a simple prognostic indicator in surgical patients.

This study evaluates hand grip strength as an indicator of nutritional status and a predictor of postoperative complications. Hand grip strength and other parameters of nutritional status, namely, midarm muscle circumference, forearm muscle circumference, triceps skinfold, percentage ideal body weight, serum albumin, and percent usual weight were determined preoperatively in 205 patients. Complications occurred in 28 patients (14%). Patients with at least one abnormal nutritional parameter had a higher incidence of postoperative complications. Their length of total and postoperative hospitalization was greater by 6.2 and 4.6 days, respectively (p less than 0.01). Grip strength was the most sensitive single parameter, but forearm muscle circumference and percentage ideal body weight were the most specific indices. Hand grip strength is a simple measure of nutritional status and an accurate prognostic indicator that requires further clinical evaluation.

Adult↗

Characterizing human hand prehensile strength by force and moment wrench.

Characterizing human hand capabilities or demand created by various occupational tasks or activities of daily living has been mainly accomplished by measuring the maximum force exerted on a force dynamometer in a number of standard grips, for example power, key pinch and tip pinch grips. A framework is proposed instead to characterize human hand prehensile strength in generic form by describing external force and moment wrench capability, where a wrench is a vector describing the forces and moments applied at a point. It is further suggested that if tools and activities are characterized by the internal forces and external forces and moments required, a better understanding of the human prehension in occupational settings and during activities of daily living can be obtained. An example of using a pistol grip drill is used to show the utility of the approach.

Biomechanical Phenomena↗

Hand grip strength and incident ADL disability in elderly Mexican Americans over a seven-year period.

BACKGROUND AND AIMS: Little is known about muscle strength as a predictor of disability among older Mexican Americans. The aim of this study was to examine the association between hand grip strength and 7-year incidence of ADL disability in older Mexican American men and women. METHODS: A 7-year prospective cohort study of 2493 non-institutionalized Mexican American men and women aged 65 or older residing in five south-western states. Maximal hand grip strength test, body mass index, cognitive function, activities of daily living, self-reports of medical conditions (arthritis, diabetes, heart attack, stroke, cancer, hip fracture), and depressive symptoms were obtained. RESULTS: In a Cox proportional regression analysis, there was a linear relationship between hand grip strength at baseline and risk of incident ADL disability over a 7-year follow-up. Among non-disabled men at baseline, the hazard ratio of any new ADL limitation was 1.90 (95% CI 1.14-3.17) for those in the lowest quartile, when compared with men in the highest hand grip strength quartile, after controlling for age, marital status, medical conditions, high depressive symptoms, MMSE score, and BMI at baseline. Among non-disabled women at baseline, the hazard ratio of any new ADL limitation was 2.28 (95% CI 1.59-3.27) for those in the lowest quartile, when compared with women in the highest hand grip strength quartile. CONCLUSIONS: Hand grip strength is an independent predictor of ADL disability among older Mexican American men and women. The hand grip strength test is an easy, reliable, valid, inexpensive method of screening to identify older adults at risk of disability.

Activities of Daily Living↗

Physical performance characteristics of women with fibromyalgia.

OBJECTIVE: The aim of this study was to examine physical performance in women with fibromyalgia (FM) using methods that are easy to use in clinical settings and to compare our findings with published norms or a healthy comparison group. METHODS: Measures of shoulder pain and range-of-motion, isometric shoulder endurance, neck rotation, leg strength, hand grip strength, back flexibility, 6-minute walk distance, and symptom duration were completed on 97 subjects with FM. The comparison group was 30 age-matched healthy women. RESULTS: The FM group had significantly lower physical functioning scores on all variables when compared to the healthy group or published norms. When pain at rest was controlled, pain on motion was the most significant predictor of variance in shoulder range of motion, whereas range of motion was the most significant predictor of right shoulder endurance and grip strength of both hands. CONCLUSIONS: Women with FM are markedly below average in physical performance abilities when measured by clinical tests.

Adult↗

Stability and change in genetic and environmental influences on hand-grip strength in older male twins.

The aim of this study was to investigate aging-related changes in the contribution of genetic and environmental influences to hand-grip strength in late adulthood. Subjects in this study are 152 intact twin pairs (77 monozygotic and 75 dizygotic pairs) from the National Heart, Lung, and Blood Institute Twin Study assessed repeatedly for hand-grip strength at mean ages of 63 and 73 yr. Structural equation genetic modeling was used to investigate stability and change in the genetic and environmental components of variance of hand-grip strength in late adulthood. Average decline in strength over the 10 yr of follow-up was -1.05+/-6.8 (SD) kg and was highly significant (P = 0.003). The test-retest correlation between baseline and follow-up grip strength was 0.62 (P<0.001). Bivariate genetic modeling found significant genetic and shared environmental stability in hand-grip strength over the 10 yr of follow-up, with genetic and shared environmental influences accounting for 35 and 48%, respectively, of the test-retest phenotypic correlation. We conclude from these results that stability in hand-grip strength in late adulthood is due primarily to continuity of genetic and familial influences.

Aged↗