Grip and pinch strength: Reference values for children and adolescents from India

Is the handgrip pressure influenced by the same factors in typical children and adolescents and those with spina bifida?

OBJECTIVE

To investigate the factors influencing handgrip pressure (HGP) in typical children and adolescents and those with spina bifida (SB).

METHODS

This cross-sectional study enrolled 126 typical participants and 58 with SB, aged 8-16 years, categorized into subgroups: typical children (typical prepubertal; n = 20), typical adolescents (typical pubertal and post-pubertal; n = 106), SB children (SB prepubertal; n = 11), and SB adolescents (SB pubertal and post-pubertal; n = 47). Data on sex, height (or wingspan), lean and fat body mass, and levels of physical activity and spinal cord injury were collected. Participants performed three maximal voluntary isometric contractions of HGP using a bulb dynamometer. Multiple linear regression analyses examined the relationship between variables and HGP.

RESULTS

In typical children, decreases in height, fat and lean body mass were associated with decreased HGP. In typical adolescents, females exhibited higher HGP than males, and increases in lean body mass and height were positively associated with HGP; and sedentary individuals exhibited higher HGP compared to active counterparts. In SB adolescents, increases in fat and lean body mass were associated with higher HGP, and greater physical activity was associated with stronger HGP. Participants with sacral injury level showed higher HGP than those with thoracic injury level. No association was observed for SB children.

CONCLUSION

Except for SB children, various factors, mainly the lean body mass, significantly influenced the HGP in all groups. When the outcome is HGP, it is important to monitor body composition and physical activity in typical children and adolescents and those with SB.

Efficacy of Plyometric Exercises Versus Wii Training on Upper Extremity Function in Children With Unilateral Cerebral Palsy: A Comparative Study

ObjectivesTo compare between the effects of plyometric exercises versus Wii on upper extremity functions in children with unilateral cerebral palsy (UCP).MethodForty-two children with UCP, ranging in age from 8 to 12 years were allocated to receive plyometric exercises (PLYO -group) or Wii training (Wii-group) for 45 min. both groups received selected occupational therapy programs for 30 min twice a week over 3-month. The intervention was delivered on non-consecutive days. The quality of upper extremity skills test (QUEST), Test of arm selective control (TASC) and pneumatic squeeze bulb dynamometer were used to assess upper extremity function, SMC and HGS, respectively.ResultsOverall, 42 children (21 in the PLYO-group, 21 in the Wii-group) completed data collection and treatment. With-in group comparison showed significant improvement in both groups while post-treatment comparisons revealed a significant difference from mean difference in upper extremity function is 9.55 (8.71:10.39), SMC is 2.05 (1.47: 2.63) and HGS is 2.86 (2.20: 3.53) (p < 0.05; 95% Confidence interval) in favor of the PLYO-group.ConclusionsPlyometric exercises are significantly more effective than Wii training in improving upper extremity function and strength in children with UCP.

Strength and dexterity of less affected hand of children with unilateral cerebral palsy: a comparison study with normal peers

BACKGROUND/AIM

A key aspect of hand function is dexterity, which is described as fine voluntary movements used to manipulate small objects during a specific task. The contralateral hand in children with unilateral cerebral palsy (U-CP); is commonly referred to as a "good" and "unimpaired" hand, while others have noted that it has subtle limitations. Therefore, this study aimed to assess and compare between the strength and dexterity of less-affected hand of children with U-CP and the dominant hand of normal peers.

METHODS

A sample of 120 volunteer children from both sexes and age ranged from 6 to 10 years participated in this study. Out of the 120 children, sixty were normal typically developing (TD) and sixty children with U-CP. Assessment of fine motor dexterity and grip and pinch strength were carried out by the Functional dexterity test (FDT) and Pneumatic squeeze Blub Dynamometer respectively.

RESULTS

The results showed that there was a significant lower in pinch and grip strength (p < 0.01) and significant higher FDT scores of children with U-CP compared with that of TD children (p = 0.001). Moreover, there was a significant higher functional levels in TD children compared with that of children with U-CP (p < 0.001) with no significant difference between groups in penalty distribution (p > 0.05).

CONCLUSION

Children with U-CP underperformed with their less-affected hand than the dominant hand of TD age matched peers. Future researches on bilateral hand function may be used to determine the best rehabilitation interventions.

Handgrip Strength in Lung Transplant Candidates and Recipients

OBJECTIVES

Handgrip strength is increasingly used to assess muscle strength in various conditions. In this review, we investigated handgrip strength in patients receiving or awaiting lung transplant.

MATERIALS AND METHODS

For this integrative review, we searched 8 databases from inception through February 2023. Two keyword entries, "handgrip strength" and "lung transplantation," were matched using the Boolean operator, AND. No filters were applied for document type, age, sex, publication date, language, and subject.

RESULTS AND CONCLUSIONS

The searched databases returned 73 citations. Nine articles considering 487 patients (49% female) were included in the final analysis; 7 studies were observational, and 2 were randomized controlled trials. In 7 of 9 studies, handgrip strength was measured with a hydraulic dynamometer. In candidates for lung transplant, handgrip strength ranged from 27.1 kg (before rehabilitation) to 31.2 kg (after rehabilitation). In lung transplant recipients, handgrip strength ranged from 21.1 kg (before rehabilitation) to 35.7 kg (after rehabilitation). Handgrip strength in lung transplant candidates with chronic obstructive pulmonary disease was higher (89 ± 18% predicted) versus patients with interstitial lung disease (79 ± 18% predicted). Improvements in maximal inspiratory pressure and maximal expiratory pressure were observed in those patients whose handgrip strength improved after rehabilitation. Nonsarcopenic patients walked longer distances for the 6-minute walking test (>450 m) versus sarcopenic patients (<310 m) and had higher handgrip strength (>20 kg) versus sarcopenic patients (<20 kg). Handgrip strength testing should be implemented both in preoperative and postoperative contexts to evaluate physical potential of patients and drive rehabilitative activities toward the most impaired domains.

Differential Relationship of Grip Strength with Body Composition and Lifestyle Factors Between Indian Urban and Rural Boys and Girls

OBJECTIVES

To assess grip strength and gender differences in grip strength in 9-18-y-old urban and rural Indian children, to study association of grip strength with body composition, and assess determinants of grip strength.

METHODS

This was part of a multicenter, cross-sectional, school-based study (n = 1978, mean age 13.3 ± 2.2 y) from three urban and rural states. Anthropometry, body composition, dietary intake, physical activity, sunlight exposure, and grip strength (in kg) were measured.

RESULTS

Mean grip strength increased with age but plateaued in girls after 12 y and was higher in boys (19.6 ± 9.2) than girls (14.3 ± 5.3) (p < 0.05). Mean grip strength was higher in urban (21.05 ± 9.7) than in rural boys (17.8 ± 8.2) (p < 0.05), and comparable in urban (14.9 ± 5.2) and rural girls (13.8 ± 5.5). Grip strength in girls remained lower than boys after adjusting for muscle mass. Difference between boys and girls reduced after body size [body mass index (BMI)] correction, but remained low in girls, plateauing after 15 y. Muscle mass and age were significant determinants of grip strength in all children. On addition of lifestyle factors to the model, grip strength was explained to varied degrees in the children.

CONCLUSION

In boys, nutrition through body size and composition was largely responsible for the differences in grip strength, and in girls, additionally, sociocultural factors also possibly impacted grip strength.

Handgrip strength and its correlation with anthropometric determinants and hand dimensions in children aged 6-12 years: A cross-sectional study

BACKGROUND

Handgrip strength is considered an important interpreter of general health, and hand functions in children. It is mainly influenced by anthropometric determinants and hand dimensions.

OBJECTIVE

To assess the handgrip strength and their association with anthropometric determinants, hand circumference, hand span, and hand length among school children in both the dominant and non-dominant hand.

METHODS

Anthropometric measurements, hand circumference, hand span, hand length, and grip strength measurements were obtained from 133 school children of both genders aged 6-12 years. A Jamar hand-held dynamometer was used to measure handgrip strength and the hand dimensions with a tape measure in cm.

RESULTS

Significant differences were found between the handgrip strength among boys and girls. The dominant hand was found to be sturdier than the non-dominant hand in both genders. We also found a significant correlation of anthropometric determinants and hand dimensions with handgrip strength. Age, BMI, hand circumference, hand span, and hand length had a strong correlation with grip strength (p < 0.01).

CONCLUSIONS

The study revealed the reference values and concluded its correlations with hand dimensions among school children aged 6-12 years and this information can serve as a manual for interpretation of handgrip strength measurements in children.

Pinch grip strength and fine manual control in children with diplegic cerebral palsy: a cross-sectional study

Background

In children with spastic diplegia, efficient use of the upper extremity especially the hands play an important role in participation in daily living. Hands can perform heavy activities and also enable to perform extremely gentle, skillful, and precise activities. Inadequate hand strength and fine motor skills may lead to functional limitations. This study was planned to investigate the pinch grip strength and fine manual control in children with spastic diplegic cerebral palsy and to determine if there is a relation between them. Thirty children with diplegic cerebral palsy and 30 normal developed children from both sexes between 5 and 10 years old were included in this study as diplegic and control groups. For all children, pinch grip strength measured by Baseline Mechanical Pinch Gauge and Bruininks-Oseretsky Test of Motor Proficiency, Second Edition used to evaluate fine manual control.

Results

Children with diplegic cerebral palsy have significant impairment in the pinch grip strength (tip, tripod, and key) and the fine manual control (fine motor precision and integration) compared to their healthy peers of the same age. There was large positive significant correlation (r > 0.5, p < 0.05) between tip and tripod pinch strength, and fine motor precision and medium positive significant correlation (r = 0.47, p < 0.05) between key pinch and fine motor precision in children with spastic diplegia. Also, there was large positive significant correlation between tip pinch and fine motor integration (r = 0.54, p < 0.05). The correlations are small and medium positive between tripod and key pinch strength, and fine motor integration respectively but they are not statistically significant.

Conclusions

Pinch grip strength and fine manual skills are affected in children with spastic diplegia. Also, there is a significant correlation between the pinch strength and activities require precise control of the hand.

Hand anthropometry and its relation to grip/pinch strength in children aged 5 to 13 years

Objective

To evaluate the development level of children’s physiological hand shape indicators and their relationship with grip/pinch strength.

Methods

Hand shape and grip/pinch strength in 1255 Chinese children aged 5 to 13 years were prospectively measured. Development curves of physiological hand shape indicators and grip/pinch strength were constructed.

Results

The physiological hand shape indicators (full length, middle finger length, width, and wrist thickness) and grip/pinch strength of boys and girls increased with age and showed statistically significant differences at different ages. In most age groups, hand shape indicators and grip/pinch strength were larger in boys than in girls of the same age. After puberty, the physiological hand shape indicators and grip/pinch strength increased more rapidly in girls than in boys of the same age, and the differences gradually decreased thereafter. Moreover, a significant difference in pinch strength between the right and left hands was observed in most age groups. Pearson correlation analysis showed that the physiological hand shape indicators were significantly positively correlated with grip/pinch strength, height, weight, and body mass index.

Conclusions

This study revealed the relationship between physiological hand shape indicators and grip/pinch strength and provided reference ranges of physiological hand shape indicators and grip/pinch strength for children.

Temporal Muscle as an Indicator of Sarcopenia is Independently Associated with Hunt and Kosnik Grade on Admission and the Modified Rankin Scale Score at 6 Months of Patients with Subarachnoid Hemorrhage Treated by Endovascular Coiling

OBJECTIVE

Sarcopenia is defined as the loss of skeletal muscle mass and is considered an important factor for clinical outcomes in various diseases. Recent studies have shown that temporal muscle thickness (TMT) and area (TMA) can be novel indicators of sarcopenia. We examined clinical characteristics, including TMT and TMA, of patients with subarachnoid hemorrhage (SAH) treated by endovascular coiling.

METHODS

A retrospective analysis of 298 patients with SAH who were treated with endovascular coiling from 2009 to 2019 was conducted. Their premorbid modified Rankin Scale (mRS) score was 0-2. The association between the factors and Hunt and Kosnik (H-K) grades on admission and that between the clinical variables and mRS scores 6 months after the operation were analyzed.

RESULTS

In all 298 patients with SAH, Fisher group 4 and TMA <200 mm² were independently associated with H-K grade III-V on admission in the multivariate analysis. In 254 patients with H-K grades I-III on admission, age, H-K grade III, presence of ventriculoperitoneal shunt, presence of postoperative complications, and TMA <200 mm² were independent factors related to poor outcomes in the multivariate analysis.

CONCLUSIONS

The H-K grade on admission was independently associated with TMA. The mRS score 6 months after aneurysm treatment in patients with H-K grades I-III was also independently associated with TMA. Sarcopenia could be one of a few modifiable factors that prevent severe symptoms of SAH and improve outcomes after coiling by strengthened nutrition and physical activity.