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Grip and Pinch Strength: Normative data for adults

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Abstract

The primary purpose of this study was to establish clinical norms for adults aged 20 to 75+ years on four tests of hand strength. A dynamometer was used to measure grip strength and a pinch gauge to measure tip, key, and palmar pinch. A sample of 310 male and 328 female adults, ages 20 to 94, from the seven-county Milwaukee area were tested using standardized positioning and instructions. Right hand and left hand data were stratified into 12 age groups for both sexes. This stratification provides a means of comparing the score of individual patients to that of normal subjects of the same age and sex. The highest grip strength scores occurred in the 25 to 39 age groups. For tip, key, and palmar pinch the average scores were relatively stable from 20 to 59 years, with a gradual decline from 60 to 79 years. A high correlation was seen between grip strength and age, but a low to moderate correlation between pinch strength and age. The newer pinch gauge used in this study appears to read higher than that used in a previous normative study. Comparison of the average hand strength of right-handed and left-handed subjects showed only minimal differences.
... No problems or side effects were encountered during any of the measurements. The measured grip strength and the calculated VO 2 max were provided to subjects along with age specific norms for both the grip strength [28] and VO 2 max [29]. In 2014 participants were given an age specific "good" norm VO 2 max and in 2015 were provided a "superior" norm for VO 2 max [29] to determine if increasing the normative value would have a greater impact on subsequent exercise behavior. ...
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Abstract Background Regular physical activity and exercise provide many health benefits. These health benefits are mediated in large part through cardiorespiratory fitness and muscular strength. As most individuals have not had an assessment of their personal cardiorespiratory fitness or muscular strength we investigated if measurements of cardiorespiratory fitness and muscular strength would influence an individual’s subsequent self-reported exercise and physical activity. Methods Volunteer subjects at a State Fair were randomized in 1:1 parallel fashion to control and intervention groups. The baseline Exercise Vital Sign (EVS) and type of physical activity were obtained from all subjects. The intervention group received estimated maximum oxygen uptake (VO2max) using a step test and muscular strength using a hand grip dynamometer along with age-specific norms for both measurements. All subjects were provided exercise recommendations. Follow up surveys were conducted at 3, 6 and 12 months regarding their EVS and physical activity. Results One thousand three hundred fifteen individuals (656 intervention, 659 control) were randomized with 1 year follow up data obtained from 823 subjects (62.5%). Baseline mean EVS was 213 min/week. No change in EVS was found in either group at follow-up (p = 0.99). Subjects who were less active at baseline (EVS
... Female participants were selected as RA is more prevalent in this group and hand strength has been reported to have a curvilinear relationship with age (27,28), and is largely stable between 20 and 50 years (27). Moreover, as musculoskeletal conditions can negatively impact on upper limb strength and the upper-body strength of healthy female subjects has been shown to be 40-70% less than male equivalents (29), it was considered that the upper limb strength of the healthy female participants would adequately represent the upper limit of deforming force that could be applied to the WHO by either gender when presenting with wrist/hand dysfunction. ...
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Objective: Wrist-hand orthoses (WHOs) are prescribed for a range of musculoskeletal/neurological conditions to optimise wrist/hand position at rest and enhance performance by controlling its range of motion (ROM), improving alignment, reducing pain, and optimising grip strength. The objective of this research was to study the efficacy and functionality of ten commercially available WHOs on wrist ROM and grip strength. Design: Randomised comparative functional study of the wrist/hand with and without WHOs. Participants: Ten right-handed female participants presenting with no underlying condition nor pain affecting the wrist/hand which could influence motion or grip strength. Each participant randomly tested ten WHOs; one per week, for 10 weeks. Main outcome measures: The primary outcome was to ascertain the impact of WHOs on wrist resting position and flexion, extension, radial, and ulnar deviation. A secondary outcome was the impact of the WHOs on maximum grip strength and associated wrist position when this was attained. Results: From the 2,400 tests performed it was clear that no WHO performed effectively or consistently across participants. The optimally performing WHO for flexion control was #3 restricting 86.7%, #4 restricting 76.7% of extension, #9 restricting 83.5% of radial deviation, and #4 maximally restricting ulnar deviation. A grip strength reduction was observed with all WHOs, and ranged from 1.7% (#6) to 34.2% (#4). Conclusion: WHOs did not limit movement sufficiently to successfully manage any condition requiring motion restriction associated with pain relief. The array of motion control recorded might be a contributing factor for the current conflicting evidence of efficacy for WHOs. Any detrimental impact on grip strength will influence the types of activities undertaken by the wearer. The design aspects impacting wrist motion and grip strength are multifactorial, including: WHO geometry; the presence of a volar bar; material of construction; strap design; and quality of fit. This study raises questions regarding the efficacy of current designs of prefabricated WHOs which have remained unchanged for several decades but continue to be used globally without a robust evidence-base to inform clinical practise and the prescription of these devices. These findings justify the need to re-design WHOs with the goal of meeting users' needs.
... The 6MWT was completed using a 30-meter corridor and standardised encouragement. The Baseline Lite Hydraulic handgrip dynamometer (Fabrication Enterprises Inc.) was used to assess hand-grip strength and data from this device correlates with the Jamar dynamometer [20], which has demonstrated validity and reliability in the oncology population [21]. The validated 30-second sit-to-stand test (30secSTS), performed according to standard protocols, assessed lower limb strength and function [22]. ...
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Purpose To evaluate the impact of routine multidisciplinary allied health prehabilitation care in haematologic cancer patients receiving high-dose chemotherapy with autologous stem cell transplant (AuSCT). Methods In a tertiary cancer centre, 12-months of prospectively collected data was retrospectively analysed. Patients were referred to the service for individualised exercise prescription, nutrition intervention and, if indicated through screening, psychological intervention. Impact and operational success were investigated based on the RE-AIM framework: patient uptake of the service and sample representativeness (Reach); Effectiveness in terms of changes in outcomes from initial to pre-transplant assessment; Adoption of the service by key stakeholders; fidelity of the prescribed exercise program (Implementation); and the extent to which the service had become part of routine standard care (Maintenance). Results 183 patients were referred to the AuSCT service, of whom 133 (73%) were referred into the prehabilitation service, 128 (96%) were eligible and 116 (91%) participated. Significant improvements were demonstrated between initial and pre-transplant assessments particularly six-minute walk distance (n = 45); mean difference (95% CI) 39.9m (18.8 to 61.0, p = < 0.005). Missing data were an issue for assessment of effectiveness. Fidelity of exercise prescription was moderate with 72% of eligible patients receiving the intended aerobic and resistance exercise interventions. Conclusion The prehabilitation service was well adopted by clinicians. Clinically relevant improvements in outcomes were demonstrated. Recommendations, including development of well-integrated discipline-specific assessment intervention and measurement protocols, are highlighted to improve the service. Prehabilitation should be routinely considered to support the care of patients undergoing AuSCT.
... Total scores ranged from 0 (complete dependence) to 100 (complete independence). (v) Hand grip strength test (Mathiowetz et al. 1985). ...
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Motor learning interacts with and shapes experience-dependent cerebral plasticity. In stroke patients with paresis of the upper limb, motor recovery was proposed to reflect a process of re-learning the lost/impaired skill, which interacts with rehabilitation. However, to what extent stroke patients with hemiparesis may retain the ability of learning with their affected limb remains an unsolved issue, that was addressed by this study. Nineteen patients, with a cerebrovascular lesion affecting the right or the left hemisphere, underwent an explicit motor learning task (finger tapping task, FTT), which was performed with the paretic hand. Eighteen age-matched healthy participants served as controls. Motor performance was assessed during the learning phase (i.e., online learning), as well as immediately at the end of practice, and after 90 min and 24 h (i.e., retention). Results show that overall, as compared to the control group, stroke patients, regardless of the side (left/right) of the hemispheric lesion, do not show a reliable practice-dependent improvement; consequently, no retention could be detected in the long-term (after 90 min and 24 h). The motor learning impairment was associated with subcortical damage, predominantly affecting the basal ganglia; conversely, it was not associated with age, time elapsed from stroke, severity of upper-limb motor and sensory deficits, and the general neurological condition. This evidence expands our understanding regarding the potential of post-stroke motor recovery through motor practice, suggesting a potential key role of basal ganglia, not only in implicit motor learning as previously pointed out, but also in explicit finger tapping motor tasks.
... Three measurements were taken for each hand, alternating right/left to permit muscular recovery between replicate trials. Results were recorded in kilograms (kg), the mean of three trials for each hand was recorded and the highest value of the two means was used for further analyses [32,33]. Low muscle strength was defined as hand grip strength <27 kg in men and <16 kg in women [31]. ...
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Background Aging is associated with decreases in muscle strength and simultaneous changes in body composition, including decreases in muscle mass, muscle quality and increases in adiposity. Methods Adults (n = 369; 236 females) aged 65–74 years living independently were recruited from the cross-sectional Researching Eating Activity and Cognitive Health (REACH) study. Body fat percentage and appendicular skeletal muscle mass (ASM) (sum of lean mass in the arms and legs) were assessed using Dual-energy X-ray Absorptiometry (Hologic, QDR Discovery A). The ASM index was calculated by ASM (kilograms) divided by height (meters) squared. Isometric grip strength was measured using a hand grip strength dynamometer (JAMAR HAND). Results Linear regression analyses revealed that muscle strength was positively associated with the ASM index (R ² = 0.431, p < 0.001). When exploring associations between muscle strength and muscle mass according to obesity classifications (obesity ≥30% males; ≥40% females), muscle mass was a significant predictor of muscle strength in non-obese participants. However, in participants with obesity, muscle mass was no longer a significant predictor of muscle strength. Conclusions Body fat percentage should be considered when measuring associations between muscle mass and muscle strength in older adults.
... This procedure was conducted as follows: the subjects remained seated with their shoulder adducted and neutrally rotated, elbow flexed at 90°, forearm in neutral position, and wrist between 0° and 30° dorsiflexion and between 0° and 15° ulnar deviation, collected three times with one-minute interval. The best of the three attempts was used for the strength measure (Mathiowetz et al., 1985). The relative handgrip strength (RHS) was calculated based on body mass and then divided in tertiles according to their level of RHS as Low (LS), Medium (MS) and High (HS) strength. ...
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We aimed to investigate the autonomic responses to cold pressor test (CPT) in individual with different levels of muscle strength. 57 male subjects participated in the study. Volunteers were divided in tertiles according to their level of relative handgrip strength as Low (LS), Medium (MS) and High (HS). For the CPT the volunteers remained seated in resting for 15 minutes and inserted the right hand in cold water for two minutes. Blood pressure (BP) measurements were taken at rest, during CPT and during recovery. HRV was continuously recorded during the entire protocol. All three groups had similar BP variation, with the values of systolic blood pressure (SBP) increasing during CPT and diminishing during recovery until the third minute. At the first CPT minute LS group showed a substantial increase in low-frequency (LF) activity and a diminished high frequency (HF). LS also presented higher and lower values of LF and HF, respectively, than MS group at the first CPT minute. HS showed an increased vagal activity during recovery. In conclusion, individuals from LS presented similar BP responses to CPT than MS and HS groups but with higher sympathetic activation. HS individuals presented an elevated vagal activity during recovery.
... Upper Limb Function For the assessment of upper limb function, the Fugl-Meyer assessment scale (FMA) [25], hand strength test [26], and Jebsen-Taylor hand function test (JTHFT) [27] were performed, while activities of daily living were assessed based on the Korean version of the modified Barthel Index (K-MBI) [28] and the level of rehabilitation participation was estimated based on the Pittsburgh rehabilitation participation scale [29]. The tests were carried out before and after the intervention. ...
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This study investigated the effects of a rehabilitation program using a wearable device on upper limb function, the performance of activities of daily living, and rehabilitation participation in acute phase stroke patients. A total of 44 patients were randomly divided into two groups. The experimental group (n = 22) was requested to wear a glove-type device while they were administered a game-based virtual reality (VR) rehabilitation program of 30 mins per session, 5 sessions per week, for 4 weeks. The program was given in addition to conventional physical therapy. The control group (n = 22) was administered only conventional physical therapy. To examine the intervention effects, the Fugl-Meyer assessment scale, hand strength test, and Jebsen–Taylor hand function tests were performed to examine upper limb function. The Korean version of the modified Barthel Index was used to assess the performance of activities of daily living, and the Pittsburgh rehabilitation participation scale was used to estimate rehabilitation participation. Neither the experimental nor the control group showed significant differences in the pre-intervention homogeneity test, while both groups showed significant improvement in all post-intervention dependent variables. Notably, the experimental group showed a significantly greater improvement in the results of the hand strength test, Jebsen–Taylor hand function test, and Modified Barthel Index. The findings suggest that the rehabilitation program using a wearable device, in addition to conventional physical therapy, is more effective than conventional therapy alone for improving upper limb function, the performance of activities of daily living, and rehabilitation participation in acute phase stroke patients. Our findings suggest that the novel rehabilitation program using a wearable device will serve not only as an effective therapy for enhancing the upper limb function, the performance of activities of daily living, and rehabilitation participation in acute phase stroke patients but also as a highly useful intervention in actual clinical practice alongside conventional physical therapy.
Article
Purpose Patients undergoing surgery for trapeziometacarpal (TMC) joint arthritis require preoperative counseling on the expectations of surgery. This study aims to document the objective and functional recovery over the initial 12 months following trapeziectomy and ligament reconstruction with tendon interposition (LRTI). Methods We prospectively followed 55 patients with symptomatic TMC joint osteoarthritis after trapeziectomy and LRTI. Patients were assessed on functional outcome measures, pain, and objective outcomes of grip, tip and key pinch strength, and range of motion. Outcomes were recorded preoperatively and at 3, 6, 9, and 12 months after surgery. Results Outcome measures of Disabilities of the Arm, Shoulder, and Hand (DASH), Patient-Rated Wrist Evaluation (PRWE), and pain, improved significantly after surgery at each 3-month interval up to 9 months. Palmar and radial abduction were significantly improved compared to their preoperative ranges, but opposition was unchanged. Power grip significantly exceeded the preoperative strength at 6 months and further increased at 9 months. Tip pinch significantly exceeded the preoperative strength at 12 months. There was no difference in the key pinch strength compared to the preoperative strength. Conclusions Over a follow-up period of 12 months, trapeziectomy and LRTI is an effective treatment in significantly reducing pain in 80% of patients. Although normal patient-reported outcome measures of DASH and PRWE are not regained, when compared to normative values, these measures are significantly improved; the improvement plateaus at 9 months. Patients can expect to attain 37% and 46% of their eventual measured DASH and PRWE scores, respectively, at 3 months, and 82% and 79% of their eventual measured DASH and PRWE scores, respectively, at 6 months. Grip strength exceeded the preoperative strength by 15% at 6 months and by 30% at 9 months. Tip pinch strength significantly exceeded the preoperative strength by 20% at 9 months. Type of study/level of evidence Therapeutic II.
Chapter
The interaction between muscle-generated strength and external forces can lead to dynamic or isometric activity. The muscle may develop different sized forces, depending on the realized form of action. This chapter describes several methods for measurement of muscle strength and muscle power. Limb strength and power can be measured using computerized pneumatic strength training equipment. The measurement of leg extensor power is functionally relevant, as it has been shown to be related to mobility and instrumental activities of daily living and has been identified as a risk factor for falls. Muscle power can be derived from ground reaction force resulting from a vertical jump. The measurement of handgrip strength is a common procedure in the course of geriatric assessments and used in both research and clinical practice. For stair climbing tests, inertial measurement units are used to determine the duration of climbing a specific number of stairs and calculate the power based on the definition.
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