Skip to main content
Log in

Hand grip strength measurement in different epidemiologic studies using various methods for diagnosis of sarcopenia: a systematic review

  • Review
  • Published:
European Geriatric Medicine Aims and scope Submit manuscript

Abstract

Background

The purpose of this systematic review was to compare various methods for measuring hand grip strength to provide data for the development of a standardized protocol for such a measurement based on epidemiologic studies of sarcopenia in older population.

Methods

Systematic review and meta-analysis were performed using 34 available epidemiologic studies.

Results

The choice of hand dynamometer and measurement protocols for measuring hand grip strength was not consistent among studies. Mean values of hand grip strength in older population were also different by study area (Europe, America, and Asia) and gender.

Conclusion

This systematic review demonstrated that various grip strength measurement methods were used in different epidemiologic studies. A standardized method is needed to enable more consistent measurement of grip strength and better assessment of sarcopenia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

Abbreviations

ASHT:

American Society of Hand Therapists

AWGS:

Asian Working Group for Sarcopenia

EWGSOP:

European Working Group on Sarcopenia in Older People

IWGS:

International Working Group on Sarcopenia

ICD-10-CM:

International Classification of Diseases

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

References

  1. Cao L, Morley JE (2016) Sarcopenia is recognized as an independent condition by an international classification of disease, tenth revision, clinical modification (ICD-10-CM) code. J Am Med Dir Assoc 17(8):675–677

    Article  PubMed  Google Scholar 

  2. Roberts HC, Denison HJ, Martin HJ, Patel HP, Syddall H, Cooper C et al (2011) A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age Ageing 40:423–429

    Article  PubMed  Google Scholar 

  3. Schaap LA, Fox B, Henwood T, Bruyère O, Reginster J-Y, Beaudart C et al (2016) Grip strength measurement: towards a standardized approach in sarcopenia research and practice. Eur Geriatr Med. 7:247–255

    Article  Google Scholar 

  4. Woo J, Arai H, Ng TP, Sayer AA, Wong M, Syddall H et al (2014) Ethnic and geographic variations in muscle mass, muscle strength and physical performance measures. Eur Geriatr Med 5:155–164

    Article  Google Scholar 

  5. Leong DP, Teo KK, Rangarajan S, Kutty VR, Lanas F, Hui C et al (2016) Reference ranges of handgrip strength from 125,462 healthy adults in 21 countries: a prospective urban rural epidemiologic (PURE) study. J Cachexia Sarcopenia Muscle 7:535–546

    Article  PubMed  PubMed Central  Google Scholar 

  6. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62:e1–34

    Article  PubMed  Google Scholar 

  7. The Cochrane Database of Systematic Reviews [Internet]. [cited 13 Jan 2017]. Available: http://www.cochranelibrary.com/cochrane-database-of-systematic-reviews/

  8. Hozo SP, Djulbegovic B, Hozo I (2005) Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 5:13

    Article  PubMed  PubMed Central  Google Scholar 

  9. Stang A (2010) Critical evaluation of the Newcastle–Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25:603–605

    Article  PubMed  Google Scholar 

  10. Higgins JPT, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560

    Article  PubMed  PubMed Central  Google Scholar 

  11. Spira D, Norman K, Nikolov J, Demuth I, Steinhagen-Thiessen E, Eckardt R (2016) Prevalence and definition of sarcopenia in community dwelling older people: data from the Berlin aging study II (BASE-II). Z Für Gerontol Geriatr 49:94–99

    Article  CAS  Google Scholar 

  12. Huang C-Y, Hwang A-C, Liu L-K, Lee W-J, Chen L-Y, Peng L-N et al (2016) Association of dynapenia, sarcopenia, and cognitive impairment among community-dwelling older Taiwanese. Rejuvenation Res 19:71–78

    Article  PubMed  Google Scholar 

  13. Sinesio Silva Neto L, Gomes de Oliveira Karnikowski M, Barbosa Osório N, Barbosa Mendes M, Galato D, Barbaresco Gomide L et al. (2016) Association between sarcopenia and quality of life in quilombola elderly in Brazil. Int J Gen Med 89

  14. Han P, Zhao J, Guo Q, Wang J, Zhang W, Shen S et al (2016) Incidence, risk factors, and the protective effect of high body mass index against sarcopenia in suburb-dwelling elderly Chinese populations. J Nutr Health Aging 20:1056–1060

    Article  PubMed  CAS  Google Scholar 

  15. Velazquez-Alva MC, Irigoyen Camacho ME, Lazarevich I, Delgadillo Velazquez J, Acosta Dominguez P, Zepeda Zepeda MA (2017) Comparison of the prevalence of sarcopenia using skeletal muscle mass index and calf circumference applying the European consensus definition in elderly Mexican women: sarcopenia prevalence in Mexican women. Geriatr Gerontol Int 17:161–170

    Article  PubMed  Google Scholar 

  16. Pereira FB, Leite AF, de Paula AP (2015) Relationship between pre-sarcopenia, sarcopenia and bone mineral density in elderly men. Arch Endocrinol Metab 59:59–65

    Article  PubMed  Google Scholar 

  17. Yoshida D, Suzuki T, Shimada H, Park H, Makizako H, Doi T et al (2014) Using two different algorithms to determine the prevalence of sarcopenia: prevalence of sarcopenia. Geriatr Gerontol Int. 14:46–51

    Article  PubMed  Google Scholar 

  18. Tanimoto Y, Watanabe M, Sun W, Sugiura Y, Hayashida I, Kusabiraki T et al (2014) Sarcopenia and falls in community-dwelling elderly subjects in Japan: defining sarcopenia according to criteria of the European Working Group on Sarcopenia in Older People. Arch Gerontol Geriatr 59:295–299

    Article  PubMed  Google Scholar 

  19. Wu C-H, Chen K-T, Hou M-T, Chang Y-F, Chang C-S, Liu P-Y et al (2014) Prevalence and associated factors of sarcopenia and severe sarcopenia in older Taiwanese living in rural community: the Tianliao old people study 04: Sarcopenia in community-dwelling older Taiwanese. Geriatr Gerontol Int 14:69–75

    Article  PubMed  Google Scholar 

  20. Akune T, Muraki S, Oka H, Tanaka S, Kawaguchi H, Nakamura K et al (2014) Exercise habits during middle age are associated with lower prevalence of sarcopenia: the ROAD study. Osteoporos Int 25:1081–1088

    Article  PubMed  CAS  Google Scholar 

  21. Yu R, Leung J, Woo J (2014) Incremental predictive value of sarcopenia for incident fracture in an elderly Chinese Cohort: results from the osteoporotic fractures in men (MrOs) study. J Am Med Dir Assoc 15(8):551–558

    Article  PubMed  Google Scholar 

  22. Lee W-J, Liu L-K, Peng L-N, Lin M-H, Chen L-K (2013) Comparisons of sarcopenia defined by IWGS and EWGSOP criteria among older people: results from the I-Lan longitudinal aging study. J Am Med Dir Assoc 14:528.e1–528.e7

    Google Scholar 

  23. ter Borg S, de Groot LCPGM, Mijnarends DM, de Vries JHM, Verlaan S, Meijboom S et al (2016) Differences in nutrient intake and biochemical nutrient status between sarcopenic and nonsarcopenic older adults—results from the maastricht sarcopenia study. J Am Med Dir Assoc 17:393–401

    Article  PubMed  Google Scholar 

  24. Chan R, Leung J, Woo J (2016) A prospective cohort study to examine the association between dietary patterns and sarcopenia in chinese community-dwelling older people in Hong Kong. J Am Med Dir Assoc 17:336–342

    Article  PubMed  Google Scholar 

  25. Bianchi L, Ferrucci L, Cherubini A, Maggio M, Bandinelli S, Savino E et al (2016) The predictive value of the EWGSOP definition of sarcopenia: results from the InCHIANTI study. J Gerontol A Biol Sci Med Sci 71:259–264

    Article  PubMed  Google Scholar 

  26. Cawthon PM, Blackwell TL, Cauley J, Kado DM, Barrett-Connor E, Lee CG et al (2015) Evaluation of the usefulness of consensus definitions of sarcopenia in Older men: results from the observational osteoporotic fractures in men cohort study. J Am Geriatr Soc 63:2247–2259

    Article  PubMed  PubMed Central  Google Scholar 

  27. Beaudart C, Reginster J-Y, Slomian J, Buckinx F, Locquet M, Bruyère O (2014) Prevalence of sarcopenia: the impact of different diagnostic cut-off limits. J Musculoskelet Neuronal Interact 14:425–431

    PubMed  CAS  Google Scholar 

  28. Pagotto V, Silveira EA (2014) Applicability and agreement of different diagnostic criteria for sarcopenia estimation in the elderly. Arch Gerontol Geriatr 59:288–294

    Article  PubMed  Google Scholar 

  29. Volpato S, Bianchi L, Cherubini A, Landi F, Maggio M, Savino E et al (2014) Prevalence and clinical correlates of sarcopenia in community-dwelling older people: application of the EWGSOP definition and diagnostic algorithm. J Gerontol A Biol Sci Med Sci 69:438–446

    Article  PubMed  CAS  Google Scholar 

  30. Ishii S, Tanaka T, Shibasaki K, Ouchi Y, Kikutani T, Higashiguchi T et al (2014) Development of a simple screening test for sarcopenia in older adults: sarcopenia screening. Geriatr Gerontol Int 14:93–101

    Article  PubMed  Google Scholar 

  31. Wu I-C, Lin C-C, Hsiung CA, Wang C-Y, Wu C-H, Chan D-CD et al (2014) Epidemiology of sarcopenia among community-dwelling older adults in Taiwan: a pooled analysis for a broader adoption of sarcopenia assessments: sarcopenia in an elderly population in Taiwan. Geriatr Gerontol Int 14:52–60

    Article  PubMed  Google Scholar 

  32. Meng N-H, Li C-I, Liu C-S, Lin C-H, Lin W-Y, Chang C-K et al (2015) Comparison of height- and weight-adjusted sarcopenia in a Taiwanese metropolitan older population: sarcopenia in an older Taiwanese population. Geriatr Gerontol Int 15:45–53

    Article  PubMed  Google Scholar 

  33. Bischoff-Ferrari HA, Orav JE, Kanis JA, Rizzoli R, Schlögl M, Staehelin HB et al (2015) Comparative performance of current definitions of sarcopenia against the prospective incidence of falls among community-dwelling seniors age 65 and older. Osteoporos Int 26:2793–2802

    Article  PubMed  CAS  Google Scholar 

  34. Tanimoto Y, Watanabe M, Sun W, Sugiura Y, Tsuda Y, Kimura M et al (2012) Association between sarcopenia and higher-level functional capacity in daily living in community-dwelling elderly subjects in Japan. Arch Gerontol Geriatr 55:e9–e13

    Article  PubMed  Google Scholar 

  35. Wen X, An P, Chen WC, Lv Y, Fu Q (2015) Comparisons of sarcopenia prevalence based on different diagnostic criteria in Chinese older adults. J Nutr Health Aging 19:342

    Article  PubMed  CAS  Google Scholar 

  36. Yamada M, Nishiguchi S, Fukutani N, Tanigawa T, Yukutake T, Kayama H et al (2013) Prevalence of sarcopenia in community-dwelling japanese older adults. J Am Med Dir Assoc 14:911–915

    Article  PubMed  Google Scholar 

  37. Wu C-H, Chen K-T, Hou M-T, Chang Y-F, Chang C-S, Liu P-Y et al (2014) Prevalence and associated factors of sarcopenia and severe sarcopenia in older Taiwanese living in rural community: the Tianliao Old People study 04: Sarcopenia in community-dwelling older Taiwanese. Geriatr Gerontol Int 14:69–75

    Article  PubMed  Google Scholar 

  38. Han P, Kang L, Guo Q, Wang J, Zhang W, Shen S et al (2016) Prevalence and factors associated with sarcopenia in Suburb-dwelling older chinese using the Asian working group for sarcopenia definition. J Gerontol A Biol Sci Med Sci 71:529–535

    Article  PubMed  Google Scholar 

  39. Lauretani F, Russo CR, Bandinelli S, Bartali B, Cavazzini C, Di Iorio A et al (2003) Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol 95(5):1851–1860

    Article  PubMed  Google Scholar 

  40. Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S (1985) Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil 66(2):69–74

    PubMed  CAS  Google Scholar 

  41. Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F et al (2010) Sarcopenia: european consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing 39:412–423

    Article  PubMed  PubMed Central  Google Scholar 

  42. Zhang W, Shen S, Wang W, Zhou C, Xu L, Qiu J et al. (2014) Poor lower extremity function was associated with pre-diabetes and diabetes in older Chinese people. Sergi G, editor. PLoS ONE 9: E115883

  43. Roberts HC, Denison HJ, Martin HJ, Patel HP, Syddall H, Cooper C et al (2011) A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age Ageing 40:423–429

    Article  PubMed  Google Scholar 

  44. Wang CY, Chen LY (2010) Grip strength in older adults: test-retest reliability and cutoff for subjective weakness of using the hands in heavy tasks. Arch Phys Med Rehabil 91(11):1747–1751

    Article  PubMed  Google Scholar 

  45. Fess EE, Moran CA (1981) Clinical assessment recommendations. American Society of Hand Therapists, Chicago

    Google Scholar 

  46. Grant JF, Taylor AW, Ruffin RE, Wilson DH, Phillips PJ, Adams RJ et al (2009) Cohort profile: the north west adelaide health study (NWAHS). Int J Epidemiol 38(6):1479–1486

    Article  PubMed  Google Scholar 

  47. Bruyère O, Beaudart C, Reginster J-Y, Buckinx F, Schoene D, Hirani V et al (2016) Assessment of muscle mass, muscle strength and physical performance in clinical practice: an international survey. Eur Geriatr Med. 7:243–246

    Article  Google Scholar 

  48. Yoo J-I, Choi H, Ha Y-C (2017) Mean hand grip strength and cut-off value for sarcopenia in Korean adults using KNHANES VI. J Korean Med Sci 32:868

    Article  PubMed  PubMed Central  Google Scholar 

  49. Kamide N, Kamiya R, Nakazono T, Ando M (2015) Reference values for hand grip strength in Japanese community-dwelling elderly: a meta-analysis. Environ Health Prev Med 20:441–446

    Article  PubMed  PubMed Central  Google Scholar 

  50. Perna FM, Coa K, Troiano RP, Lawman HG, Wang C-Y, Li Y et al (2016) Muscular grip strength estimates of the U.S. population from the national health and nutrition examination survey 2011–2012. J Strength Cond Res 30:867–874

    Article  PubMed  Google Scholar 

  51. Roush JR, Gombold KL, Bay RC (2017) Normative grip strength values in males and females, ages 50 to 89 years old. Internet J Allied Health Sci Pract 16:7

    Google Scholar 

  52. Balogun JA, Akomolafe CT, Amusa LO (1991) Grip strength: effects of testing posture and elbow position. Arch Phys Med Rehabil 72:280–283

    PubMed  CAS  Google Scholar 

  53. Htun NC, Ishikawa-Takata K, Kuroda A, Tanaka T, Kikutani T, Obuchi SP et al (2016) Screening for malnutrition in community dwelling older Japanese: preliminary development and evaluation of the Japanese nutritional risk screening tool (NRST). J Nutr Health Aging 20(2):114–120

    Article  PubMed  CAS  Google Scholar 

  54. Jung HW, Jang IY, Lee YS, Lee CK, Cho EI, Kang WY et al (2016) Prevalence of frailty and aging-related health conditions in older Koreans in rural communities: a cross-sectional analysis of the aging study of pyeongchang rural area. J Korean Med Sci 31(3):345–352

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  55. Han DS, Chang KV, Li CM, Lin YH, Kao TW et al (2016) Skeletal muscle mass adjusted by height correlated better with muscular functions than that adjusted by body weight in defining sarcopenia. Sci Rep 6:19457

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  56. Wang YJ, Wang Y, Zhan JK, Tang ZY, He JY, Tan P et al (2015) Sarco-osteoporosis: prevalence and association with frailty in Chinese community-dwelling older adults. Int J Endocrinol 2015:482940

    PubMed  PubMed Central  Google Scholar 

  57. Nishiguchi S, Yamada M, Fukutani N, Adachi D, Tashiro Y, Hotta T et al (2015) Differential association of frailty with cognitive decline and sarcopenia in community-dwelling older adults. J Am Med Dir Assoc 16(2):120–124

    Article  PubMed  Google Scholar 

  58. Dam TT, Peters KW, Fragala M, Cawthon PM, Harris TB, McLean R et al (2014) An evidence-based comparison of operational criteria for the presence of sarcopenia. J Gerontol A Biol Sci Med Sci 69(5):584–590

    Article  PubMed  PubMed Central  Google Scholar 

  59. Xue QL, Bandeen-Roche K, Varadhan R, Zhou J, Fried LP (2008) Initial manifestations of frailty criteria and the development of frailty phenotype in the Women’s Health and Aging Study II. J Gerontol A Biol Sci Med Sci 63(9):984–990

    Article  PubMed  Google Scholar 

  60. Fess EE (1992) Grip strength. In: Casanova JS (ed) Clinical assessment recommendations, 2nd edn. American Society of Hand Therapists, Chicago, pp. 41–45

    Google Scholar 

  61. Wu SW, Wu SF, Liang HW, Wu ZT, Huang S (2009) Measuring factors affecting grip strength in a Taiwan Chinese population and a comparison with consolidated norms. Appl Ergon 40(4):811–815

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This research was supported by a grant (HC15C1189) of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI) funded by the Ministry of Health & Welfare, Republic of Korea.

Funding

This research was supported by a grant from the Korean Health Technology R & D Project through the Korean Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HC15C1189).

Author information

Authors and Affiliations

Authors

Contributions

The study was conceived and funding was obtained by Y-CH. All authors contributed to data collection, data management, and the development of the study protocol. The manuscript was drafted by J-IY and Y-CH. All authors finalized, provided critical review, and approved the final manuscript.

Corresponding author

Correspondence to Jun-Il Yoo.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interest.

Ethics approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent to participate

Not applicable.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ha, YC., Hwang, SC., Song, SY. et al. Hand grip strength measurement in different epidemiologic studies using various methods for diagnosis of sarcopenia: a systematic review. Eur Geriatr Med 9, 277–288 (2018). https://doi.org/10.1007/s41999-018-0050-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s41999-018-0050-6

Keywords

Navigation