Grip Strength: Difference between revisions

mNo edit summary
(Technology catgory added)
Line 16: Line 16:
Grip strength grows weaker as we age, which eventually begins to affect our day-to-day. Simple things like opening jars, carrying groceries, and turning doorknobs are made more or less difficult depending on the strength of the hands.  
Grip strength grows weaker as we age, which eventually begins to affect our day-to-day. Simple things like opening jars, carrying groceries, and turning doorknobs are made more or less difficult depending on the strength of the hands.  


It is also a reliable indicator of many health conditions associated with [[Ageing Effects on Motor Control|ageing]], suggesting its utility as an inexpensive form of risk stratification for all-cause mortality and physical frailty<ref name=":0">Leong DP, Teo KK, Rangarajan S, Lopez-Jaramillo P, Avezum A, Orlandini A, Seron P, Ahmed SH, Rosengren A, Kelishadi R, Rahman O. [https://www-sciencedirect-com.ap1.proxy.openathens.net/science/article/pii/S0140673614620006?via%3Dihub Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study.] The lancet. 2015 Jul 18;386(9990):266-73.</ref><ref name=":1">Labott BK, Bucht H, Morat M, Morat T, Donath L. [[Effects of Exercise Training on Handgrip Strength in Older Adults: A Meta-Analytical Review.]] Gerontology. 2019;65(6):686-698. doi: 10.1159/000501203. Epub 2019 Sep 9. PMID: 31499496.</ref>. Implementation of grip strength measurement for older people wards as part of routine admission assessment was recommended<ref>Ibrahim K, May CR, Patel HP, Baxter M, Sayer AA, Roberts HC. [https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-018-0768-5 Implementation of grip strength measurement in medicine for older people wards as part of routine admission assessment: identifying facilitators and barriers using a theory-led intervention.] BMC geriatrics. 2018; 18(1):79. doi: 10.1186/s12877-018-0768-5.</ref> as low grip strength in older inpatients is associated with poor healthcare outcomes including longer length of stay and mortality.  A high percentage of older patients were identified to be at risk of poor healthcare outcomes as a result of low grip strength and would benefit from nutritional and exercise interventions.
It is also a reliable indicator of many health conditions associated with [[Ageing Effects on Motor Control|ageing]], suggesting its utility as an inexpensive form of risk stratification for all-cause mortality and physical frailty. <ref name=":0">Leong DP, Teo KK, Rangarajan S, Lopez-Jaramillo P, Avezum A, Orlandini A, Seron P, Ahmed SH, Rosengren A, Kelishadi R, Rahman O. [https://www-sciencedirect-com.ap1.proxy.openathens.net/science/article/pii/S0140673614620006?via%3Dihub Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study.] The lancet. 2015 Jul 18;386(9990):266-73.</ref><ref name=":1">Labott BK, Bucht H, Morat M, Morat T, Donath L. [[Effects of Exercise Training on Handgrip Strength in Older Adults: A Meta-Analytical Review.]] Gerontology. 2019;65(6):686-698. doi: 10.1159/000501203. Epub 2019 Sep 9. PMID: 31499496.</ref> Implementation of grip strength measurement for older people wards as part of routine admission assessment was recommended <ref>Ibrahim K, May CR, Patel HP, Baxter M, Sayer AA, Roberts HC. [https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-018-0768-5 Implementation of grip strength measurement in medicine for older people wards as part of routine admission assessment: identifying facilitators and barriers using a theory-led intervention.] BMC geriatrics. 2018; 18(1):79. doi: 10.1186/s12877-018-0768-5.</ref> as low grip strength in older inpatients is associated with poor healthcare outcomes including longer length of stay and mortality.  A high percentage of older patients were identified to be at risk of poor healthcare outcomes as a result of low grip strength and would benefit from nutritional and exercise interventions.
* A 2018 prospective study found better handgrip strength was associated with cardiac structure and function in a pattern indicative of less cardiac hypertrophy and remodelling. These characteristics are known to be associated with a lower risk of cardiovascular events<ref>Beyer SE, Sanghvi MM, Aung N, Hosking A, Cooper JA, Paiva JM, et al. [https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0193124 Prospective association between handgrip strength and cardiac structure and function in UK adults.] PloS one. 2018;13(3):e0193124.</ref>.
* A 2018 prospective study found better handgrip strength was associated with cardiac structure and function in a pattern indicative of less cardiac hypertrophy and remodelling. These characteristics are known to be associated with a lower risk of cardiovascular events.<ref>Beyer SE, Sanghvi MM, Aung N, Hosking A, Cooper JA, Paiva JM, et al. [https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0193124 Prospective association between handgrip strength and cardiac structure and function in UK adults.] PloS one. 2018;13(3):e0193124.</ref>
* In older patients with [[Femoral Neck Hip Fracture|hip fractures]], early grip strength evaluation might provide important prognostic information regarding the patient's future functional trajectory.<ref>Savino E, Martini E, Lauretani F, Pioli G, Zagatti AM, Frondini C, et al. [https://www.amjmed.com/article/S0002-9343(13)00482-8/abstract Handgrip strength predicts persistent walking recovery after hip fracture surgery. The American journal of medicine]. 2013;126(12):1068-75. </ref>
* In older patients with [[Femoral Neck Hip Fracture|hip fractures]], early grip strength evaluation might provide important prognostic information regarding the patient's future functional trajectory.<ref>Savino E, Martini E, Lauretani F, Pioli G, Zagatti AM, Frondini C, et al. [https://www.amjmed.com/article/S0002-9343(13)00482-8/abstract Handgrip strength predicts persistent walking recovery after hip fracture surgery. The American journal of medicine]. 2013;126(12):1068-75. </ref>
* A 2017 scoping review reported the use of handgrip strength as a way to monitor cognitive changes was important and that reduced handgrip strength over time may serve as a predictor of cognitive loss with advancing age<ref>Fritz NE, McCarthy CJ, Adamo DE. [https://www.ncbi.nlm.nih.gov/pubmed/28189666 Handgrip strength as a means of monitoring progression of cognitive decline–a scoping review.] Ageing research reviews. 2017;35:112-23. </ref>. Similarly, a 2016 review found that handgrip strength has a predictive validity for the decline in cognition, mobility, functional status and mortality in older community-dwelling populations<ref>Rijk JM, Roos PR, Deckx L, van den Akker M, Buntinx F. [https://www.ncbi.nlm.nih.gov/pubmed/26016893/ Prognostic value of handgrip strength in people aged 60 years and older: a systematic review and meta‐analysis.] Geriatrics & gerontology international. 2016;16(1):5-20. </ref>.
* A 2017 scoping review reported the use of handgrip strength as a way to monitor cognitive changes was important and that reduced handgrip strength over time may serve as a predictor of cognitive loss with advancing age. <ref>Fritz NE, McCarthy CJ, Adamo DE. [https://www.ncbi.nlm.nih.gov/pubmed/28189666 Handgrip strength as a means of monitoring progression of cognitive decline–a scoping review.] Ageing research reviews. 2017;35:112-23. </ref> Similarly, a 2016 review found that handgrip strength has a predictive validity for the decline in cognition, mobility, functional status and mortality in older community-dwelling populations. <ref>Rijk JM, Roos PR, Deckx L, van den Akker M, Buntinx F. [https://www.ncbi.nlm.nih.gov/pubmed/26016893/ Prognostic value of handgrip strength in people aged 60 years and older: a systematic review and meta‐analysis.] Geriatrics & gerontology international. 2016;16(1):5-20. </ref>
* A 2015 study also found weak grip strength to be associated with all-cause mortality, coronary heart disease, hypertension, heart failure, stroke, and chronic obstructive pulmonary disease<ref name=":0" />.
* A 2015 study also found weak grip strength to be associated with all-cause mortality, coronary heart disease, hypertension, heart failure, stroke, and chronic obstructive pulmonary disease. <ref name=":0" />
* A cross-sectional study (2020) shows a low correlation between the handgrip strength and standard strength measures of the lower limbs (hip, knee, and ankle extensor/flexor muscles), and functional capacity in older women<ref>Rodacki AL, Moreira NB, Pitta A, Wolf R, Melo Filho J, Rodacki CD, Pereira G. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335282/ Is Handgrip Strength a Useful Measure to Evaluate Lower Limb Strength and Functional Performance in Older Women?.] Clinical Interventions in Aging. 2020;15:1045.</ref>.
* A cross-sectional study (2020) shows a low correlation between the handgrip strength and standard strength measures of the lower limbs (hip, knee, and ankle extensor/flexor muscles), and functional capacity in older women. <ref>Rodacki AL, Moreira NB, Pitta A, Wolf R, Melo Filho J, Rodacki CD, Pereira G. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335282/ Is Handgrip Strength a Useful Measure to Evaluate Lower Limb Strength and Functional Performance in Older Women?.] Clinical Interventions in Aging. 2020;15:1045.</ref>
*A 2021 systematic review found low grip strength to be associated with increased risk of cognitive decline and dementia<ref>Cui M, Zhang S, Liu Y, Gang X, Wang G. [[Grip Strength and the Risk of Cognitive Decline and Dementia: A Systematic Review and Meta-Analysis of Longitudinal Cohort Studies]]. Front Aging Neurosci. 2021 Feb 4;13:625551. doi: 10.3389/fnagi.2021.625551. PMID: 33613270; PMCID: PMC7890203.</ref>.
*A 2021 systematic review found low grip strength to be associated with increased risk of cognitive decline and dementia. <ref>Cui M, Zhang S, Liu Y, Gang X, Wang G. [[Grip Strength and the Risk of Cognitive Decline and Dementia: A Systematic Review and Meta-Analysis of Longitudinal Cohort Studies]]. Front Aging Neurosci. 2021 Feb 4;13:625551. doi: 10.3389/fnagi.2021.625551. PMID: 33613270; PMCID: PMC7890203.</ref>  
*[[File:Elderly Physio.jpg|right|frameless]]


==== In Conditions of the Upper Limb ====
==== In Conditions of the Upper Limb ====
Line 38: Line 37:
* Normative data exists for grip and pinch strength testing. In addition, compare readings with the client’s opposite extremity.
* Normative data exists for grip and pinch strength testing. In addition, compare readings with the client’s opposite extremity.
* Before performing strength testing check whether there are any healing tissues that can be damaged by this test and use another outcome measure.
* Before performing strength testing check whether there are any healing tissues that can be damaged by this test and use another outcome measure.
The study measuring the validity of the digital MicroFET3 dynamometer with Jamar dynamometer suggests good validity for the MicroFET3 dynamometer. The comparison showed that the MicroFET3 dynamometer indicated age-related declines in the maximum grip-force and showed slower and more inconsistent maximal hand-grip strength generation by the elderly<ref>Lee SC, Wu LC, Chiang SL, Lu LH, Chen CY, Lin CH, Ni CH, Lin CH. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191369/ Validating the Capability for Measuring Age-Related Changes in Grip-Force Strength Using a Digital Hand-Held Dynamometer in Healthy Young and Elderly Adults.] BioMed Research International. 2020 Apr 21;2020.</ref>.
The study measuring the validity of the digital MicroFET3 dynamometer with Jamar dynamometer suggests good validity for the MicroFET3 dynamometer. The comparison showed that the MicroFET3 dynamometer indicated age-related declines in the maximum grip-force and showed slower and more inconsistent maximal hand-grip strength generation by the elderly. <ref>Lee SC, Wu LC, Chiang SL, Lu LH, Chen CY, Lin CH, Ni CH, Lin CH. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191369/ Validating the Capability for Measuring Age-Related Changes in Grip-Force Strength Using a Digital Hand-Held Dynamometer in Healthy Young and Elderly Adults.] BioMed Research International. 2020 Apr 21;2020.</ref>


A meta-analysis suggests a change of 1.6kg and above in grip strength to be real change, due to the potential technical error of measurement<ref name=":1" />.
A meta-analysis suggests a change of 1.6kg and above in grip strength to be real change, due to the potential technical error of measurement. <ref name=":1" />


=== Suggested Exercises ===
=== Suggested Exercises ===
A meta-analysis found that studies with large effects in favour of the intervention group adopted a '''multimodal approach''' to exercise training<ref name=":1" />. Presumably, handgrip strength capacity benefits more from integrating different training aspects, such as strength, balance, flexibility and endurance<ref name=":1" />. Due to the high variance in exercise dosage parameters across the literature, it is unclear what constitutes the best effect intervention for improving grip strength<ref name=":1" />. Nevertheless, the meta-analysis suggests at least 9 weeks of task-specific training with variable heart frequency, at 75% 1 RM, and at a perceived exertion level of “somewhat hard” or “hard”<ref name=":1" />.
A meta-analysis found that studies with large effects in favour of the intervention group adopted a '''multimodal approach''' to exercise training. <ref name=":1" /> Presumably, handgrip strength capacity benefits more from integrating different training aspects, such as strength, balance, flexibility and endurance.<ref name=":1" /> Due to the high variance in exercise dosage parameters across the literature, it is unclear what constitutes the best effect intervention for improving grip strength<ref name=":1" />. Nevertheless, the meta-analysis suggests at least 9 weeks of task-specific training with variable heart frequency, at 75% 1 RM, and at a perceived exertion level of “somewhat hard” or “hard”.<ref name=":1" />  


== References  ==
== References  ==
Line 57: Line 56:
[[Category:Elbow]]
[[Category:Elbow]]
[[Category:Elbow - Assessment and Examination]]
[[Category:Elbow - Assessment and Examination]]
[[Category:Technology]]

Revision as of 11:14, 12 April 2024

Original Editor - Lucinda hampton Top Contributors - Lucinda hampton, Jonathan Wong, Kim Jackson, Uchechukwu Chukwuemeka, Vidya Acharya and Angeliki Chorti

Objective[edit | edit source]

Grip .jpg

Grip strength is a measure of muscular strength or the maximum force/tension generated by one’s forearm muscles. It can be used as a screening tool for the measurement of upper body strength and overall strength. It is most useful when multiple measurements are taken over time to track performance.

Research indicates that grip strength in midlife can predict physical disability in senior years and help evaluate a patient’s overall health. All one needs is a hand dynamometer and the handgrip strength normative values.

Intended Population[edit | edit source]

Grip strength can be used in numerous situations to evaluate and track many health-related conditions, as further discussed below.

The Elderly.[edit | edit source]

Grip strength grows weaker as we age, which eventually begins to affect our day-to-day. Simple things like opening jars, carrying groceries, and turning doorknobs are made more or less difficult depending on the strength of the hands.

It is also a reliable indicator of many health conditions associated with ageing, suggesting its utility as an inexpensive form of risk stratification for all-cause mortality and physical frailty. [1][2] Implementation of grip strength measurement for older people wards as part of routine admission assessment was recommended [3] as low grip strength in older inpatients is associated with poor healthcare outcomes including longer length of stay and mortality.  A high percentage of older patients were identified to be at risk of poor healthcare outcomes as a result of low grip strength and would benefit from nutritional and exercise interventions.

  • A 2018 prospective study found better handgrip strength was associated with cardiac structure and function in a pattern indicative of less cardiac hypertrophy and remodelling. These characteristics are known to be associated with a lower risk of cardiovascular events.[4]
  • In older patients with hip fractures, early grip strength evaluation might provide important prognostic information regarding the patient's future functional trajectory.[5]
  • A 2017 scoping review reported the use of handgrip strength as a way to monitor cognitive changes was important and that reduced handgrip strength over time may serve as a predictor of cognitive loss with advancing age. [6] Similarly, a 2016 review found that handgrip strength has a predictive validity for the decline in cognition, mobility, functional status and mortality in older community-dwelling populations. [7]
  • A 2015 study also found weak grip strength to be associated with all-cause mortality, coronary heart disease, hypertension, heart failure, stroke, and chronic obstructive pulmonary disease. [1]
  • A cross-sectional study (2020) shows a low correlation between the handgrip strength and standard strength measures of the lower limbs (hip, knee, and ankle extensor/flexor muscles), and functional capacity in older women. [8]
  • A 2021 systematic review found low grip strength to be associated with increased risk of cognitive decline and dementia. [9]

In Conditions of the Upper Limb[edit | edit source]

Method of Measurement[edit | edit source]

To assess grip strength, the Jamar dynamometer is recommended by the American Society for Surgery of the Hand and the American Society of Hand Therapists.

  • The client is seated with shoulder adducted, elbow flexed to 90 degrees, and forearm and wrist neutral. The therapist places the dynamometer in the client’s hand while gently supporting the base of the dynamometer, and he/she instructs the client to squeeze as hard as possible. Grip force should be applied smoothly, without a rapid jerking motion. Allow the wrist to extend during the grip.
  • Standard grip test: Three trials on the second handle-width setting.
  • Normative data exists for grip and pinch strength testing. In addition, compare readings with the client’s opposite extremity.
  • Before performing strength testing check whether there are any healing tissues that can be damaged by this test and use another outcome measure.

The study measuring the validity of the digital MicroFET3 dynamometer with Jamar dynamometer suggests good validity for the MicroFET3 dynamometer. The comparison showed that the MicroFET3 dynamometer indicated age-related declines in the maximum grip-force and showed slower and more inconsistent maximal hand-grip strength generation by the elderly. [10]

A meta-analysis suggests a change of 1.6kg and above in grip strength to be real change, due to the potential technical error of measurement. [2]

Suggested Exercises[edit | edit source]

A meta-analysis found that studies with large effects in favour of the intervention group adopted a multimodal approach to exercise training. [2] Presumably, handgrip strength capacity benefits more from integrating different training aspects, such as strength, balance, flexibility and endurance.[2] Due to the high variance in exercise dosage parameters across the literature, it is unclear what constitutes the best effect intervention for improving grip strength[2]. Nevertheless, the meta-analysis suggests at least 9 weeks of task-specific training with variable heart frequency, at 75% 1 RM, and at a perceived exertion level of “somewhat hard” or “hard”.[2]

References[edit | edit source]

  1. ↑ 1.0 1.1 Leong DP, Teo KK, Rangarajan S, Lopez-Jaramillo P, Avezum A, Orlandini A, Seron P, Ahmed SH, Rosengren A, Kelishadi R, Rahman O. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. The lancet. 2015 Jul 18;386(9990):266-73.
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 Labott BK, Bucht H, Morat M, Morat T, Donath L. Effects of Exercise Training on Handgrip Strength in Older Adults: A Meta-Analytical Review. Gerontology. 2019;65(6):686-698. doi: 10.1159/000501203. Epub 2019 Sep 9. PMID: 31499496.
  3. ↑ Ibrahim K, May CR, Patel HP, Baxter M, Sayer AA, Roberts HC. Implementation of grip strength measurement in medicine for older people wards as part of routine admission assessment: identifying facilitators and barriers using a theory-led intervention. BMC geriatrics. 2018; 18(1):79. doi: 10.1186/s12877-018-0768-5.
  4. ↑ Beyer SE, Sanghvi MM, Aung N, Hosking A, Cooper JA, Paiva JM, et al. Prospective association between handgrip strength and cardiac structure and function in UK adults. PloS one. 2018;13(3):e0193124.
  5. ↑ Savino E, Martini E, Lauretani F, Pioli G, Zagatti AM, Frondini C, et al. Handgrip strength predicts persistent walking recovery after hip fracture surgery. The American journal of medicine. 2013;126(12):1068-75.
  6. ↑ Fritz NE, McCarthy CJ, Adamo DE. Handgrip strength as a means of monitoring progression of cognitive decline–a scoping review. Ageing research reviews. 2017;35:112-23.
  7. ↑ Rijk JM, Roos PR, Deckx L, van den Akker M, Buntinx F. Prognostic value of handgrip strength in people aged 60 years and older: a systematic review and meta‐analysis. Geriatrics & gerontology international. 2016;16(1):5-20.
  8. ↑ Rodacki AL, Moreira NB, Pitta A, Wolf R, Melo Filho J, Rodacki CD, Pereira G. Is Handgrip Strength a Useful Measure to Evaluate Lower Limb Strength and Functional Performance in Older Women?. Clinical Interventions in Aging. 2020;15:1045.
  9. ↑ Cui M, Zhang S, Liu Y, Gang X, Wang G. Grip Strength and the Risk of Cognitive Decline and Dementia: A Systematic Review and Meta-Analysis of Longitudinal Cohort Studies. Front Aging Neurosci. 2021 Feb 4;13:625551. doi: 10.3389/fnagi.2021.625551. PMID: 33613270; PMCID: PMC7890203.
  10. ↑ Lee SC, Wu LC, Chiang SL, Lu LH, Chen CY, Lin CH, Ni CH, Lin CH. Validating the Capability for Measuring Age-Related Changes in Grip-Force Strength Using a Digital Hand-Held Dynamometer in Healthy Young and Elderly Adults. BioMed Research International. 2020 Apr 21;2020.
Retrieved from "https://www.physio-pedia.com/index.php?title=Grip_Strength&oldid=353242"