"Grip and pinch strength: normative data for adults." The life course epidemiology framework recognises that factors which promote healthy ageing may operate both by increasing the peak grip strength obtained in early adult life as well as by attenuating decline thereafter [10]. This difference may have arisen as in their sample, they include 25 men at ages 2029 with mean (SD) grip 61.1 (10.5) kg. Centiles shown 10, 25th, 50th, 75th and 90th. Boissy, P., Bourbonnais, D., et al. We looked for evidence of kurtosis in the grip strength values by using the Box-Cox power exponential distribution. Commenting is closed on this page, though you can read some previous comments below which may answer some of your questions. Clin Rehabil 21(3): 248-257. If this is an emergency, please dial 911, A Young Scientist's Journey after a Stroke, Care by the Numbers: Skilled Nursing versus Inpatient Rehabilitation, WSJ: Recognizing Aphasia and Seeking Treatment, Shirley Ryan AbilityLab Ranked No. 0000010594 00000 n We restricted the data to the first observation for each individual. Our findings have confirmed that grip strength increases to a peak in early adult life and is then followed by a period of maintenance prior to decline with increasing age and that this age related decline in grip strength starts as early as the fifth decade of life in both men and women. J Hum Kinet 31(1): 25-36. (2009). 0000133748 00000 n The average of the left tripod pinch was 104.9% of the right hand. 0000015525 00000 n Values shown in brackets are the gender-specific cut-off values calculated by subtracting the relevant number of standard deviations (2 or 2.5) from the young adult peak mean. [14] reported that dominant hand was 10% stronger than non-dominant hand in right hand dominant individuals and the strengths of right and left hand had no difference in left hand dominant individuals. MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom, Affiliation Content of this site is available under Creative Commons Attribution 4.0 License Copyright The Lothian Birth Cohort 1936 was funded by Age UK (Disconnected Mind project). Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals. xZs6*|dRkPJ>w!,L&x!1RYHjuvm[~]=~W*{ Bx!'K4Hw{7a9p0 D%iDVz'|SmTNr 3{YJUU|}tJe 8[P https://doi.org/10.1371/journal.pone.0113637.g001, https://doi.org/10.1371/journal.pone.0113637.t002. No, Is the Subject Area "Aging" applicable to this article? Toll-Free U.S. Grip and pinch strengths are important parameters when evaluating the power of the hand [7-9]. "Handgrip strength testing: a review of the literature." Find it on PubMed. The Newcastle 85+ Study was funded by grants from the UK Medical Research Council (G0500997), the Dunhill Medical Trust (R124/0509), and the Newcastle Healthcare Charity. For more information about PLOS Subject Areas, click For more information about PLOS Subject Areas, click PLOS ONE promises fair, rigorous peer review, in 1985 [22] showed the grip strength peaked in thirties (52.8kg in men and 32.6kg in female). (1999). For three types of pinch strengths, key pinch was the strongest, followed by tripod pinch and tip pinch. Our results expand on the range of ages as well as the contributing sample sizes of existing studies presenting normative data for grip strength. Find it on PubMed, Bertrand, A. M., Mercier, C., et al. 1590 0 obj <>stream Before measuring grip and pinch strength, all 515 individuals were asked to complete a standardized questionnaire regarding demographic information, occupation, current medical status, histories of disease or fracture that were related to hand or upper extremities. Pleasee-mail us! The MRC National Survey of Health and Development is funded by the UK Medical Research Council. %PDF-1.5 Figure 5: Distribution (probability density function) of grip strength of the left hand dominant men (left) and the left hand dominant women (right) : right hand (blue), left hand (red). Clin Rehabil 13(4): 354-362. All pinch strengths peaked in thirties except the tip pinch in men (peaked in forties) and the tripod pinch was the strongest among them. R/ $/]!ft@#h`6qE;@$;Nj2+] Cy)-=LV:%0pH{x!A. All studies had received relevant ethical approval and all participants gave informed consent. This study was approved by the Institutional Review Board at our institution. J Nov Physiother 1:102. doi:10.4172/2165-7025.1000102. Estimated prevalence of weak grip strength in mid and late adult life, defined by gender-specific T-scores of less than or equal to 2 and 2.5, are shown in Figure 2. Grip strength and hand dominance: challenging the 10% rule. 0000004399 00000 n As such the relationships shown with age may partly represent cohort effects [45]. 0000011265 00000 n Since no studies have measured grip strength at all stages of the life course, it is necessary to combine data from studies at different ages. First, our data contained a limited range of birth years (at most 32 years) for any given ten year age group. 0000009356 00000 n We considered differences between previously published mean values and our median values for grip strength at a selection of ages, expressed as a percentage of our value. Several attempt is usually required to get the maximum score. Lindstrom-Hazel, D., Kratt, A., et al. "Validity of the Dexter Evaluation System's Jamar dynamometer attachment for assessment of hand grip strength in a normal population." The dynamometer handle is usually adjusted (if possible) to fit the hand or set at the same setting for everyone. 0000053789 00000 n The limitation of this study is that we tried to describe grip and pinch strengths with examinees age, sex, hand dominance. Percept Mot Skills 61(3 Pt 2): 1195-1198. Sensitivity analyses suggested our findings were robust to differences in dynamometer type and measurement position. We defined a T-score for grip strength as an individuals value expressed as a multiple of the number of standard deviations below the peak mean value encountered in young adult life. For collating and collecting data, we thank the LBC1921 and LBC1936 research teams and the research nurses and staff at the Wellcome Trust Clinical Research Facility at the Western General Hospital, Edinburgh. The cut-off for weak grip in men is not stated in their paper but we presume it is then 40 kg (61.1 less 210.5) substantially higher than our own (32kg). The funding is provided by the National Institute on Aging (grants 2RO1AG7644-01A1 and 2RO1AG017644) and a consortium of UK government departments coordinated by the Office for National Statistics. They can be used in setting surgical or rehabilitation goals or comparing different treatment methods. Open Orthop J 2: 86-90. It showed that tip, key and tripod pinch strengths had a positive linear correlation with the grip strength. Our objective was to produce cross-sectional centile values for grip strength across the life course. Changes in body position from protocol will result in altered grip strengths (Richards et al., 1996), The positioning of the handle will affect result in measurement discrepancies, instrument should be set at the second position on hydraulic instruments (Innes, 1999), Maximal grip is the mean of three trials, studies have shown that the mean of three trials is the most accurate measure of hand strength (Mathiowetz, V., Weber, K. et al., 1984), It is recommended that a 3 second or less grip contraction is sufficient to register maximum reading (Innes, 1999), 60 second rest periods between trials may prevent fatigue although studies have shown measurements taken at shorter durations result in minimal differences (Innes, 1999), Instrument calibration is required annually or more frequently if used on a daily basis (Roberts et al., 2011), Use the same test instrument for pre and post-testing for accurate results, Coefficient of variation (CV), a statistical stability of measures, is based on three trials of maximum grip strength at a single setting. Physiotherapy & Physical Rehabilitation Journal. "Normative data for grip strength of elderly men and women." CJ is supported by the AXA Research Fund. 2 0 obj Tripod pinch: Tripod pinch increased with aging and peaked in thirties (mean 9.77kg in men and 6.68kg in women). Discover a faster, simpler path to publishing in a high-quality journal. We therefore always used the maximum of these values for our analyses, since the maximum is less likely to be affected by the number of trials than the mean [26]. 0000003633 00000 n Copyright: 2014 Dodds et al. Studies on the peculiarity of grip strength in relation to body positions and aging. 0000002608 00000 n 0000003876 00000 n We anticipated a smooth relationship with age and therefore used a maximum number of degrees of freedom of seven and increased the standard penalty. "Reliability and validity of grip and pinch strength evaluations." vk0(Hb/I2. 0000008169 00000 n We produced dynamometer-specific sets of centile curves by allowing the median, variation and skewness curves to vary by dynamometer type. Males reached a peak median grip of 51 kg (to the nearest whole kg) between ages 29 and 39, compared to the peak female median grip of 31 kg between ages 26 and 42. This study was approved by the Institutional Review Board at our institution. Knowledge of the normative data on hand grip strength will be very helpful for the evaluation and treatment of hand or upper extremities injuries. J Rehabil Med 33(1): 36-41. Clearly there is a need to examine similar relationships in a longitudinal fashion if individual values of grip strength are to be used as a marker of those at risk of adverse outcomes. Yes Arch Gerontol Geriatr 54(1): 21-27. After 5 minutes of break, grip strength and three types of pinch strength were measured again with the same manner, and the average strengths were obtained respectively. In comparison to our main results, we generally saw centile differences of less than 10 per cent when restricting the data to the first observation for each individual, and when producing centile curves stratified by dynamometer type. Hb```f``a`c`cf@ aV( K}O05-rtv{e,4. Sensitivity analyses (see Figures S1, S2, and S3 in File S1) suggested that the centile curves were robust to the inclusion of repeat measurements of grip strength and protocol differences between studies. Figure 2: Jamar pinch gauge (Pinch Gauge, PG 60, B&L Engineering, Tustin, CA, USA) and the position of measurement (A) Jamar pinch gauge dynamometer (B) Tip pinch is thumb to index finger (C) Key pinch is thumb pad to lateral aspect of middle phalanx of index finger (D) Tripod pinch is thumb pad to pads of index and middle fingers. "How forearm position affects grip strength." The results can also be affected by the position of the wrist, elbow and shoulder, so these should be standardized. Finally a study from Denmark [40] stratified values into five height groups, the middle of which were similar to our own values. The majority (n=10) of studies had measured grip strength at one or two waves, with LBC1921 and N85 having data from three and four waves, respectively. 0000011037 00000 n Among 280 female patients, 260 patients (92.8%) were right hand dominant and 20 patients (7.2%) were left hand dominant. Grip strength was measured using the Jamar hand dynamometer (Hydraulic Hand Dynamometer, 5030J1, Sammons Preston, Bolingbrook, IL, USA). A T-score of less than or equal to 2 has previously been used by Lauretani et al [31] for grip strength, although the prevalence figures for weak strength that they report using this value, especially those for men, are considerably higher than our own. Figure S1, Centiles from first observation per individual only. This supports the use of peak values from early adult life to define cut-offs for weak grip at subsequent ages using T-scores. "Maximal grip force in chronic stroke subjects and its relationship to global upper extremity function." %PDF-1.3 % All included males and females. Peolsson, A., Hedlund, R., et al. Although our centiles appeared to be robust to differences in measurement protocol, this does not detract from the importance of recent calls for standardisation in future data collections [26], [49]. in 1995 [11], grip strength peaked in twenties in both sexes (43.97.3kg in men and 27.31.5kg in women). Bechtol et al. (2008). Table 1: Correlation coefficient between grip and pinch strengths. The Lothian Birth Cohort 1921 was funded by the Biotechnology and Biological Sciences Research Council, by a Royal Society-Wolfson Research Merit Award, and by the Scottish Government's Chief Scientist Office. endobj here. Taken together, this meant that the total number of grip strength values we could use in analyses varied: either three (ADNFS and LBC1921), four (N85 and the first wave of NSHD) or six (the remainder). It is also important for any sport in which the hands are used for catching, throwing or lifting. Normative data on grip and pinch strengths are valuable in determining the degree of hand or upper extremity injuries or disabilities either from musculoskeletal or the neurological system of the hand. There is considerable interest in its role as a marker of healthy ageing, as an outcome in intervention studies, and as a potential tool for clinical assessment [7][9]. Normative data from studies identified in childhood and adolescence varied in their relationship to our findings: either broadly similar [33], consistently higher [34] (on average 27%), or similar at young ages and higher at older ages [35] (on average 9% higher overall). var md = new Date(document.lastModified) Am J Occup Ther 49(7): 637-644. This instrument is scored using force production in kilograms (0-90) or pounds (0-200). And we had provided informed consent. We think the old Korean culture correlating the right side with goodness and the left side with evil can influence some of the left hand dominant individuals having them use non-dominant hands in younger age. The influence of wrist position on the force produced by the finger flexors. Strength of the intrinsic muscles ofthe hand measured with a hand-held dynamometer: reliabilityin patients with ulnar and median nerve paralysis. stream (r = .84) (Figure 4). Institute for Social and Economic Research, University of Essex, Colchester, United Kingdom, Affiliation In our study, the number of left and right hand dominant individuals were 42 (8.2%) and 473 (91.2%) respectively. broad scope, and wide readership a perfect fit for your research every time. Find it on PubMed, Mathiowetz, V., Kashman, N., et al. hb```-,@ 98408(L!`Ix>u=6RBx3gd t.anp|q2lNz MB is funded by the University of Essex and ESRC. 0000014423 00000 n Enter your zip code . (1999). 1997-2022 Topend Sports Network Figure 3: Scatter plot showing right grip strength as a function of age (left) and a plot showing left grip strength as a function of right grip strength (right) : men (blue), women (red). Yes The average of tip pinch, key pinch, and tripod pinch of the left hand showed 95.24%, 94.31%, and 95.28% of the right hand respectively. The majority of studies used three trials from each hand, except for N85 and the first wave of NSHD, which used two trials. Finally selection and loss-to-follow up biases may have influenced our centile values; however we included a wide range of population based studies from different geographical regions of GB and the centile curves were robust to the exclusion of any individual study. Third, we have not considered the potential impact of recognised determinants of grip strength, such as height, on the centile values presented. Conceived and designed the experiments: RD HES RC DK CC AAS. "Testretest reliability of grip-strength measures obtained over a 12-week interval from community-dwelling elders." Your gift of Ability affects everythingwe do every day at Shirley Ryan AbilityLab from the highest-quality clinical care and groundbreaking research to community programs that improve quality of life. Eight of the twelve studies had measured grip strength in mid-late adult life, as reflected by the median age of the observations: 58 years (IQR 3669 years). Figure 1: Jamar grip strength dynamometer (Hydraulic Hand Dynamometer, 5030J1) and the position of measurement (A) Jamar dynamometer is set at the level II (B) The subject is in a seated position with the shoulder adducted, not rotated to either side, and the elbow flexed to 90 degrees with the forearm and wrist in neutral position. Core support for the ALSPAC study is provided by the UK Medical Research Council and Wellcome Trust (092731). No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, Corrections, Expressions of Concern, and Retractions, https://doi.org/10.1371/journal.pone.0113637. Social & Public Health Sciences Unit, Medical Research Council, Glasgow, United Kingdom, Affiliations 0000001946 00000 n MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom, Affiliation Finally, extensive sensitivity analyses demonstrated that our centile curves for grip strength are robust to differences in the position (seated or standing) and the dynamometer used for measurement. https://doi.org/10.1371/journal.pone.0113637, Editor: Jose Vina, University of Valencia, Spain, Received: September 3, 2014; Accepted: October 27, 2014; Published: December 4, 2014. In 2021, your cash gifts may also favorably impact your taxes, thanks to the extension of many of the charitable provisions in the Coronavirus Aid, Relief and Economic Security (CARES) Act. All studies took measurements from both hands except ADNFS which used the dominant hand only (except in case of injury), and LBC1921 which measured both hands but provided values from only the dominant hand for analyses. Richards, L. G., Olson, B., et al. "Estimating minimal clinically important differences of upper-extremity measures early after stroke." 0000001718 00000 n Funding: RD is supported by a Wellcome Trust Fellowship (Grant number WT099055AIA). Wrote the paper: RD. The American Journal of Occupational Therapy 50(2): 133-138. (2007). Which setting of the dynamometer provides maximal grip strength? 194lbs you must be a huge 12-year-old. [11] where there were only 2 left hand dominant individuals out of 477). Our study had a similar result. It is important that any cut-off values relate to relevant outcomes. Find it on PubMed. We found no evidence of skewness or kurtosis in grip strength at any age. Then they declined gradually throughout life for both men and women. Our results suggested three overall periods: an increase to peak in early adult life, maintenance through to midlife, and decline from midlife onwards. There is therefore a requirement for normative data for grip strength which cover all stages of the life course. It may therefore be that a T-score of 2.5 (equivalent to 16 kg in females and 27 kg in males) produces a more discriminatory cut-off for weak grip with 23.0% of males and 26.6% of females at or below this level at age 80. The Hertfordshire Ageing Study and the Hertfordshire Cohort Study were funded by the UK Medical Research Council, the Wellcome Trust, Arthritis Research United Kingdom and the University of Southampton. <>>> (1995). Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom, Affiliation Healthy Adults and Patients with Primary Osteoarthritis of the hand (POAH): (Ziv et al, 2008;n= 32 POAH; mean age 70.4 (10),n= 25 healthy adults; mean age 74.6 (8.4); measured twice within one week; Jamar dynamometer), (Vassilis, G., 2012;n= 90; three groups: prepubertal 9.8(0.7), adolescents 14.4 (0.6), and adults 26.1 (5.6); three maximal isometric contractions on each hand, two occasions, one day apart), (Massy-Westropp et al, 2011; 1366 mean and 1312 women, community based Australian population, healthy adults, Jamar hand dynamometer), Men Hand Grip Strength in kilograms: Mean(SD), Women Hand Grip Strength in kilograms: Mean(SD), (Mathiowetz et al, 1985; 628 volunteers between the ages of 20 - 94, free from disease or injury that can affect UE strength; Jamar dynamometer in pounds), (Mathiowetz et al, 1984; n = 27; mean age 25; female OT students; two separate observations), (Reddon et al., 1985, n = 12, 6 men (21 to 36 yr.), 6 women (20 to 31 yr.), tested weekly for 10 weeks), (Lindstrom-Hazel et al., 2009, n = 73 convenience sample, three trials bilaterally, healthy students, facility, and staff members from Midwest University), (Mathewetz, V., 2002; n = 60; 30 females 30-49 years old mean 38.4 and 30 males 20-50 mean age 37.8; free from any neuromuscular or orthopedic dysfunction; testing between Jamar and Rolyan dynamometers), (Peolsson, 2001; n = 32; mean age = 29; convenient sample healthy adults; three test leaders), (Bellace et al, 2000; n = 62; ages of 18-50, randomized order of testing between Jamar and Dexter dynamometer; healthy adults), (Nitschke et al, 1999; n = 42; mean age 32.3 (7.3) healthy female subjects & 42.6 (11.8) nonspecific regional pain in upper arm female subjects; Jamar dynamometer), Abizanda, P., Navarro, J. L., et al.