Hand Grip Strength as a Vital Marker For Health and Muscle Function
A narrative review of evidences.
This study is a narrative review, published in the Journal of Health, Population, and Nutrition (2024). It comprehensively examines hand grip strength (HGS) as a biomarker and potential new vital sign reflecting overall health status, particularly in aging and various diseases.
PMID: 38195493
Key Points
Aim and Background
The review aims to synthesise evidence on the relationship between HGS and health outcomes, including morbidity and mortality, proposing HGS as an important clinical vital sign alongside traditional measures like pulse and blood pressure. It highlights HGS as a simple, non-invasive, and reliable measure of muscle function and physical capability, closely linked to sarcopenia-the age-related decline in muscle mass and strength.
Methods
The authors conducted a literature search on PubMed, Scopus, and Google Scholar between August 10 and 30, 2023, using keywords such as “hand grip strength,” “muscle strength,” “sarcopenia,” “osteosarcopenia,” "health biomarker,” “osteoporosis,” and “frailty” to identify relevant studies on HGS and health.
Findings
Measurement of HGS
HGS is typically measured using hand-held dynamometers (HHD), with the Jamar hydraulic dynamometer being a common, reliable tool.
Measurement protocols vary slightly but generally involve the participant squeezing the dynamometer with maximal effort, usually seated with the arm supported, elbow at 90 degrees, and wrist in a neutral position.
Testing in a standing position may capture broader muscle strength including lower body and core, while seated testing focuses more on hand and wrist muscles.
Relative HGS (absolute HGS divided by BMI) may better predict cardiometabolic risk than absolute HGS alone.
Normative Values and Cut-offs
Normative HGS values vary by age, sex, ethnicity, and population. Men typically have higher HGS than women, and dominant hands are stronger than non-dominant.
Peak HGS is typically reached in the 30s and declines thereafter.
Asian populations tend to have lower HGS values compared to Caucasians.
Various studies have proposed cut-offs for defining low HGS or sarcopenia, for example, <27.5 kg in males and <18.0 kg in females for an Indian population.
Associations with Health Outcomes
Low HGS correlates with multiple adverse health conditions including type 2 diabetes, cardiovascular disease, stroke, chronic kidney and liver disease, certain cancers, sarcopenia, osteoporosis, and fragility fractures.
It is also linked to increased hospitalisation, poorer nutritional status, higher overall mortality, and reduced quality of life.
HGS reflects not only upper limb strength but also overall muscle function, making it a valuable marker for general health and physical frailty.
Related
Practical Takeaways
Measuring HGS can provide a quick and reliable indicator of overall muscle strength and health status.
Regular HGS assessment can help identify early muscle weakness or sarcopenia, especially in aging individuals.
Maintaining or improving grip strength through resistance training and physical activity may contribute to better health outcomes and reduced risk of chronic diseases.
Using relative HGS (adjusted for body size) may offer a more accurate health risk prediction than absolute grip strength alone.
Key Takeaways
Hand grip strength is a simple, non-invasive, and reliable biomarker of muscle function and overall health.
It has strong associations with chronic diseases, frailty, morbidity, and mortality.
Normative values and cut-offs vary by population, necessitating population-specific standards.
HGS measurement should be standardised and incorporated into routine clinical assessments as a new vital sign to monitor health across the lifespan better.
This review strongly supports the clinical utility of HGS as an important health biomarker and advocates for its broader adoption in health assessments and disease risk stratification
Reference
Vaishya R, Misra A, Vaish A, Ursino N, D'Ambrosi R. Hand grip strength as a proposed new vital sign of health: a narrative review of evidences. J Health Popul Nutr. 2024 Jan 9;43(1):7. doi: 10.1186/s41043-024-00500-y. PMID: 38195493; PMCID: PMC10777545.