Handgrip Strength in Health Applications: A Review of the Measurement Methodologies and Influencing Factors

Handgrip strength and platelet-to-albumin ratio as joint prognostic indicator for patients with cancer cachexia

BACKGROUND

Handgrip strength (HGS) and platelet-to-albumin ratio (PAR) are established prognostic markers of cancer cachexia. This study evaluates the combined efficacy of HGS and PAR using a single index (HPA) for predicting survival outcomes in cancer patients with cachexia aged ≥18 years.

METHODS

The multicenter Nutrition Status and Its Clinical Outcomes in Common Cancers study, conducted from July 2013 to April 2022, enrolled 5189 participants. Thresholds for HGS and PAR were determined using optimal stratification, leading to the development of HPA index. Prognostic accuracy was assessed using time-dependent receiver operating characteristic analysis, Kaplan-Meier survival curves, and Cox proportional hazards models.

RESULTS

The cohort consisted of 3127 men and 2062 women, with a median follow-up of 36 months, and mean age of 58 years. Low HGS thresholds were 19 kg (female) and 31.9 kg (male), and high PAR cut-offs were 9.07 × 10⁹ (female) and 6.52 × 10⁹ (male). Both low HGS and high PAR levels were linked to increased mortality risk. The HPA index showed superior prognostic accuracy (C-index = 0.611; 95% confidence interval: 0.58-0.61; P < 0.001) compared with HGS or PAR alone. Kaplan-Meier analysis indicated significantly reduced survival in patients with low HGS and high PAR.

CONCLUSIONS

The HPA index is a clinically significant prognostic tool for cancer cachexia, enhancing survival prediction and guiding patient management.

Synergistic Effects of Medium-Chain Triglyceride Supplementation and Resistance Training on Physical Function and Muscle Health in Post-Stroke Patients

Background/Objectives: Sarcopenia and malnutrition are common in post-stroke patients, impairing recovery. Medium-chain triglycerides (MCT) may support muscle metabolism, while chair-stand exercises improve strength and mobility. However, their combined effects remain unclear. This study evaluated the synergistic effects of MCT supplementation and high-frequency chair-stand exercise on physical function and muscle health in post-stroke patients. Methods: A retrospective cohort study included 1080 post-stroke patients categorized into three groups: (1) MCT supplementation alone, (2) chair-stand exercise alone, and (3) both combined. MCT supplementation consisted of ~40 g/day MCT oil or powder. Functional outcomes were assessed using the Functional Independence Measure (FIM-motor), while muscle health was evaluated by handgrip strength (HGS) and skeletal muscle index (SMI). Multiple linear regression analyses were performed, adjusting for confounders. Results: The combined intervention group showed significantly greater improvements in FIM-motor scores at discharge (B = 8.79, 95% CI: 5.64-11.95, β = 0.32, p < 0.001) and FIM-motor gain (B = 6.02, 95% CI: 3.42-8.62, β = 0.29, p < 0.001) compared to the control. Increases in HGS (B = 2.441, 95% CI: 0.483-4.398, β = 0.18, p = 0.015) and SMI (B = 0.194, 95% CI: 0.102-0.419, β = 0.12, p = 0.039) were also observed. Chair-stand exercise was performed a median of 62 times/day and independently improved outcomes, while MCT alone had limited effects. Conclusions: MCT supplementation combined with chair-stand exercise enhances functional recovery and muscle health in post-stroke patients, supporting its role in rehabilitation. Further research is needed to evaluate long-term effects and to examine the pharmacokinetics of MCTs, including blood concentrations, in broader populations.

[Comment on the article "Hand strength and high blood pressure, a case-control study"]

Hand grip strength has been widely used in various areas of medicine as an indicator of sarcopenia, nutritional status, risk of cognitive diseases, chronic degenerative diseases and as a predictor of mortality. Several studies have evaluated the relationship between hand grip strength and blood pressure, even though the results have not been conclusive because there are several proven factors that influence hand strength. Therefore, it is relevant to evaluate this relationship in the Mexican population since there are few studies in this field.

A grip strength prediction tool for older adults based on logistic regression: construction, validation, and clinical application value

Handgrip strength is a key indicator of overall health in older adults, and its decline is linked to various adverse health outcomes. Despite numerous studies on factors influencing handgrip strength, few attempts have integrated multiple factors into a practical clinical tool. This study aims to develop and validate a nomogram based on a logistic regression model to predict the risk of low handgrip strength in older adults. Using data from the China Health and Retirement Longitudinal Study (CHARLS), 1138 participants were included. Firth-adjusted logistic regression identified predictors of low handgrip strength, with variable selection based on the Bayesian Information Criterion (BIC). Model performance was assessed using calibration curves, ROC curves, and decision curve analysis (DCA). Internal validation was performed with 10-fold cross-validation and bootstrapping, determining the optimal risk threshold. Key predictors identified included age, chronic disease history, marital status, lifestyle, education, BMI, activities of daily living, and glycated hemoglobin. The simplified model exhibited good discriminatory ability (AUC = 0.78) and calibration performance. The optimal threshold (0.40) yielded sensitivity of 72.5% and specificity of 69.8%. Decision curve analysis confirmed significant net benefit within the clinically relevant threshold range. The nomogram provides a practical tool for identifying at-risk individuals and guiding intervention, integrating modifiable and non-modifiable factors for personalized risk assessment and early intervention.

Validity and reliability of Gripwise digital dynamometer in the assessment of handgrip strength in older adults

Introduction

With the advancement of studies on the importance of sarcopenia in the aging process, new technologies have been developed to assess muscle mass and function. However, most research on portable devices has not considered a wide range of ages and clinical conditions. This study aimed to evaluate the reliability of the Gripwise digital dynamometer in measuring handgrip strength in older Brazilian adults, comparing its performance with the widely used Saehan device.

Methods

A cross-sectional study was conducted with 149 participants (32 men and 117 women), with an average age of 69.5 years. Handgrip strength was measured using both the Gripwise and Saehan dynamometers. Reliability was assessed using the intraclass correlation coefficient (ICC). Analyses considered three handgrip strength measurements from both devices, as well as the highest value obtained. The classification of dynapenia (low muscle strength) was compared using different cutoff points proposed by Villain et al. (2023), Spexoto et al. (2022), and Cruz-Jentoft et al. (2019).

Results

Both dynamometers demonstrated excellent reliability, with ICC values above 0.90. However, significant differences in mean handgrip strength values were observed between the devices (approximately 3.5-four kgf). These variations impacted the classification of dynapenia, with the Gripwise identifying more cases of low muscle strength compared to Saehan.

Conclusion

The lower values reported by the Gripwise may impact clinical decision-making in two ways. On one hand, lower values may lead to earlier detection of muscle weakness, allowing for quicker intervention in individuals with strength below typical thresholds. However, this could also result in an overestimation of the prevalence of dynapenia if the values do not accurately reflect true muscle strength, which could lead to unnecessary interventions. Therefore, it is crucial to consider the need for adjustments in the cutoff points when using Gripwise. These findings highlight the need to revise cutoff points for dynapenia classification, considering device variations and model differences in older age groups.

Nonlinear Dynamics Analysis of Handgrip Strength Using the Poincaré Plot Method Through Video Processing Techniques

BACKGROUND/OBJECTIVES

The aim of this study was to analyze the nonlinear dynamics of handgrip strength (HGS) in young adults, focusing on hand dominance, by employing the Poincaré plot method to assess short- and long-term variability utilizing dynamometry and video motion capture during sustained isometric contractions.

METHODS

A cross-sectional exploratory study was conducted on 30 healthy subjects (mean age 21.6 ± 1.3 years, 13 males and 17 females), measuring HGS for both the dominant hand (DH) and nondominant hand (NDH) using a Saehan hydraulic dynamometer during 25-s sustained isometric contractions. A GoPro HERO11 Black camera recorded the dynamometer's needle movements, and the video data were analyzed using Kinovea software. Angular values were converted to force using a calibration-based formula, and the Poincaré plot computed variability indices (short-term variability-SD1, long-term variability-SD2, ratio SD1/SD2, and area of the fitting ellipse) for each hand in relation to HGS and angular velocity (AV). Data analysis included descriptive and inferential statistics.

RESULTS

We demonstrated a strong correlation between mechanical and video measurements (p ≤ 0.001), confirming the reliability of the video method. The findings highlight the importance of nonlinear analysis in understanding neuromuscular function and fatigue, revealing significant correlations among HGS, AV, Poincaré indices, and fatigue levels in both hands (p ≤ 0.001). Increased maximum HGS and AV correlated with higher nonlinear variability in force production.

CONCLUSIONS

This study confirms the reliability of the proposed video-based HGS assessment and demonstrates the effectiveness of Poincaré plot analysis for capturing nonlinear variability in HGS.