Assessment of maximal handgrip strength: How many attempts are needed?

Esmee M. Reijnierse; Nynke de Jong; Marijke C. Trappenburg; Gerard Jan Blauw; Gillian Butler-Browne; Helena Gapeyeva; Jean Yves Hogrel; Jamie S. Mcphee; Marco V. Narici; Sarianna Sipilä; Lauri Stenroth; Rob C. van Lummel; Mirjam Pijnappels; Carel G M Meskers; Andrea B. Maier

doi:10.1002/jcsm.12181

Assessment of maximal handgrip strength: How many attempts are needed?

Esmee M. Reijnierse, Nynke de Jong, Marijke C. Trappenburg, Gerard Jan Blauw, Gillian Butler-Browne, Helena Gapeyeva, Jean Yves Hogrel, Jamie S. Mcphee, Marco V. Narici, Sarianna Sipilä, Lauri Stenroth, Rob C. van Lummel, Mirjam Pijnappels, Carel G M Meskers, Andrea B. Maier^*

^*Corresponding author for this work

Biomechanics

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

BACKGROUND: Handgrip strength (HGS) is used to identify individuals with low muscle strength (dynapenia). The influence of the number of attempts on maximal HGS is not yet known and may differ depending on age and health status. This study aimed to assess how many attempts of HGS are required to obtain maximal HGS.

METHODS: Three cohorts (939 individuals) differing in age and health status were included. HGS was assessed three times and explored as continuous and dichotomous variable. Paired t-test, intraclass correlation coefficients (ICC) and Bland-Altman analysis were used to test reproducibility of HGS. The number of individuals with misclassified dynapenia at attempts 1 and 2 with respect to attempt 3 were assessed.

RESULTS: Results showed the same pattern in all three cohorts. Maximal HGS at attempts 1 and 2 was higher than at attempt 3 on population level (P < 0.001 for all three cohorts). ICC values between all attempts were above 0.8, indicating moderate to high reproducibility. Bland-Altman analysis showed that 41.0 to 58.9% of individuals had the highest HGS at attempt 2 and 12.4 to 37.2% at attempt 3. The percentage of individuals with a maximal HGS above the gender-specific cut-off value at attempt 3 compared with attempts 1 and 2 ranged from 0 to 50.0%, with a higher percentage of misclassification in middle-aged and older populations.

CONCLUSIONS: Maximal HGS is dependent on the number of attempts, independent of age and health status. To assess maximal HGS, at least three attempts are needed if HGS is considered to be a continuous variable. If HGS is considered as a discrete variable to assess dynapenia, two attempts are sufficient to assess dynapenia in younger populations. Misclassification should be taken into account in middle-aged and older populations.

Original language	English
Pages (from-to)	466-474
Number of pages	9
Journal	Journal of Cachexia, Sarcopenia and Muscle
Volume	8
Issue number	3
Early online date	2 Feb 2017
DOIs	https://doi.org/10.1002/jcsm.12181
Publication status	Published - Jun 2017

Bibliographical note

Funding

The authors certify that they comply with the ethical guidelines for authorship and publishing of the Journal of Cachexia, Sarcopenia and Muscle: update 2015. We thank M. Stijntjes, J.H. Pasma, A.Y. Bijlsma, Y. Barnouin, T. Maden-Wilkinson, K.S. van Schooten for their contributions to collect the data. This study was supported by the seventh framework programme MYOAGE (HEALTH-2007-2.4.5-10), 050-060-810 Netherlands Consortium for Healthy Aging and by the Dutch Technology Foundation STW, which is part of the Netherlands Organisation for Scientific Research, and partly funded by the Ministry of Economic Affairs, Agriculture, and Innovation. This study was also supported by the PANINI programme (Horizon 2020, Marie Curie, Sklodowska, Innovative Training Network, No 675003) and by PreventIT (European Union's Horizon 2020 Research and Innovation Programme, No 689238).

Funders	Funder number
Horizon 2020, Marie Curie
PreventIT
Horizon 2020 Framework Programme	689238, 675003
Nederlandse Organisatie voor Wetenschappelijk Onderzoek
Stichting voor de Technische Wetenschappen
Horizon 2020
Ministerie van Economische Zaken, Landbouw en Innovatie
seventh framework programme MYOAGE	HEALTH-2007-2.4.5-10

Keywords

Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Cohort Studies
Cross-Sectional Studies
Geriatric Assessment
Hand Strength
Health Status
Humans
Middle Aged
Muscle Strength
Reproducibility of Results
Young Adult

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Reijnierse, E. M., de Jong, N., Trappenburg, M. C., Blauw, G. J., Butler-Browne, G., Gapeyeva, H., Hogrel, J. Y., Mcphee, J. S., Narici, M. V., Sipilä, S., Stenroth, L., van Lummel, R. C., Pijnappels, M., Meskers, C. G. M., & Maier, A. B. (2017). Assessment of maximal handgrip strength: How many attempts are needed? Journal of Cachexia, Sarcopenia and Muscle, 8(3), 466-474. https://doi.org/10.1002/jcsm.12181

@article{63aca2e2e82d451d9e0616cd66739335,

title = "Assessment of maximal handgrip strength: How many attempts are needed?",

abstract = "BACKGROUND: Handgrip strength (HGS) is used to identify individuals with low muscle strength (dynapenia). The influence of the number of attempts on maximal HGS is not yet known and may differ depending on age and health status. This study aimed to assess how many attempts of HGS are required to obtain maximal HGS.METHODS: Three cohorts (939 individuals) differing in age and health status were included. HGS was assessed three times and explored as continuous and dichotomous variable. Paired t-test, intraclass correlation coefficients (ICC) and Bland-Altman analysis were used to test reproducibility of HGS. The number of individuals with misclassified dynapenia at attempts 1 and 2 with respect to attempt 3 were assessed.RESULTS: Results showed the same pattern in all three cohorts. Maximal HGS at attempts 1 and 2 was higher than at attempt 3 on population level (P < 0.001 for all three cohorts). ICC values between all attempts were above 0.8, indicating moderate to high reproducibility. Bland-Altman analysis showed that 41.0 to 58.9% of individuals had the highest HGS at attempt 2 and 12.4 to 37.2% at attempt 3. The percentage of individuals with a maximal HGS above the gender-specific cut-off value at attempt 3 compared with attempts 1 and 2 ranged from 0 to 50.0%, with a higher percentage of misclassification in middle-aged and older populations.CONCLUSIONS: Maximal HGS is dependent on the number of attempts, independent of age and health status. To assess maximal HGS, at least three attempts are needed if HGS is considered to be a continuous variable. If HGS is considered as a discrete variable to assess dynapenia, two attempts are sufficient to assess dynapenia in younger populations. Misclassification should be taken into account in middle-aged and older populations.",

keywords = "Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Cohort Studies, Cross-Sectional Studies, Geriatric Assessment, Hand Strength, Health Status, Humans, Middle Aged, Muscle Strength, Reproducibility of Results, Young Adult",

author = "Reijnierse, {Esmee M.} and {de Jong}, Nynke and Trappenburg, {Marijke C.} and Blauw, {Gerard Jan} and Gillian Butler-Browne and Helena Gapeyeva and Hogrel, {Jean Yves} and Mcphee, {Jamie S.} and Narici, {Marco V.} and Sarianna Sipil{\"a} and Lauri Stenroth and {van Lummel}, {Rob C.} and Mirjam Pijnappels and Meskers, {Carel G M} and Maier, {Andrea B.}",

note = "{\textcopyright} 2017 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf on the Society on Sarcopenia, Cachexia and Wasting Disorders.",

year = "2017",

month = jun,

doi = "10.1002/jcsm.12181",

language = "English",

volume = "8",

pages = "466--474",

journal = "Journal of Cachexia, Sarcopenia and Muscle",

issn = "2190-5991",

publisher = "Springer Verlag",

number = "3",

}

Reijnierse, EM, de Jong, N, Trappenburg, MC, Blauw, GJ, Butler-Browne, G, Gapeyeva, H, Hogrel, JY, Mcphee, JS, Narici, MV, Sipilä, S, Stenroth, L, van Lummel, RC, Pijnappels, M, Meskers, CGM & Maier, AB 2017, 'Assessment of maximal handgrip strength: How many attempts are needed?', Journal of Cachexia, Sarcopenia and Muscle, vol. 8, no. 3, pp. 466-474. https://doi.org/10.1002/jcsm.12181

TY - JOUR

T1 - Assessment of maximal handgrip strength

T2 - How many attempts are needed?

AU - Reijnierse, Esmee M.

AU - de Jong, Nynke

AU - Trappenburg, Marijke C.

AU - Blauw, Gerard Jan

AU - Butler-Browne, Gillian

AU - Gapeyeva, Helena

AU - Hogrel, Jean Yves

AU - Mcphee, Jamie S.

AU - Narici, Marco V.

AU - Sipilä, Sarianna

AU - Stenroth, Lauri

AU - van Lummel, Rob C.

AU - Pijnappels, Mirjam

AU - Meskers, Carel G M

AU - Maier, Andrea B.

PY - 2017/6

Y1 - 2017/6

N2 - BACKGROUND: Handgrip strength (HGS) is used to identify individuals with low muscle strength (dynapenia). The influence of the number of attempts on maximal HGS is not yet known and may differ depending on age and health status. This study aimed to assess how many attempts of HGS are required to obtain maximal HGS.METHODS: Three cohorts (939 individuals) differing in age and health status were included. HGS was assessed three times and explored as continuous and dichotomous variable. Paired t-test, intraclass correlation coefficients (ICC) and Bland-Altman analysis were used to test reproducibility of HGS. The number of individuals with misclassified dynapenia at attempts 1 and 2 with respect to attempt 3 were assessed.RESULTS: Results showed the same pattern in all three cohorts. Maximal HGS at attempts 1 and 2 was higher than at attempt 3 on population level (P < 0.001 for all three cohorts). ICC values between all attempts were above 0.8, indicating moderate to high reproducibility. Bland-Altman analysis showed that 41.0 to 58.9% of individuals had the highest HGS at attempt 2 and 12.4 to 37.2% at attempt 3. The percentage of individuals with a maximal HGS above the gender-specific cut-off value at attempt 3 compared with attempts 1 and 2 ranged from 0 to 50.0%, with a higher percentage of misclassification in middle-aged and older populations.CONCLUSIONS: Maximal HGS is dependent on the number of attempts, independent of age and health status. To assess maximal HGS, at least three attempts are needed if HGS is considered to be a continuous variable. If HGS is considered as a discrete variable to assess dynapenia, two attempts are sufficient to assess dynapenia in younger populations. Misclassification should be taken into account in middle-aged and older populations.

AB - BACKGROUND: Handgrip strength (HGS) is used to identify individuals with low muscle strength (dynapenia). The influence of the number of attempts on maximal HGS is not yet known and may differ depending on age and health status. This study aimed to assess how many attempts of HGS are required to obtain maximal HGS.METHODS: Three cohorts (939 individuals) differing in age and health status were included. HGS was assessed three times and explored as continuous and dichotomous variable. Paired t-test, intraclass correlation coefficients (ICC) and Bland-Altman analysis were used to test reproducibility of HGS. The number of individuals with misclassified dynapenia at attempts 1 and 2 with respect to attempt 3 were assessed.RESULTS: Results showed the same pattern in all three cohorts. Maximal HGS at attempts 1 and 2 was higher than at attempt 3 on population level (P < 0.001 for all three cohorts). ICC values between all attempts were above 0.8, indicating moderate to high reproducibility. Bland-Altman analysis showed that 41.0 to 58.9% of individuals had the highest HGS at attempt 2 and 12.4 to 37.2% at attempt 3. The percentage of individuals with a maximal HGS above the gender-specific cut-off value at attempt 3 compared with attempts 1 and 2 ranged from 0 to 50.0%, with a higher percentage of misclassification in middle-aged and older populations.CONCLUSIONS: Maximal HGS is dependent on the number of attempts, independent of age and health status. To assess maximal HGS, at least three attempts are needed if HGS is considered to be a continuous variable. If HGS is considered as a discrete variable to assess dynapenia, two attempts are sufficient to assess dynapenia in younger populations. Misclassification should be taken into account in middle-aged and older populations.

KW - Adolescent

KW - Adult

KW - Age Factors

KW - Aged

KW - Aged, 80 and over

KW - Cohort Studies

KW - Cross-Sectional Studies

KW - Geriatric Assessment

KW - Hand Strength

KW - Health Status

KW - Humans

KW - Middle Aged

KW - Muscle Strength

KW - Reproducibility of Results

KW - Young Adult

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UR - http://www.scopus.com/inward/citedby.url?scp=85011655240&partnerID=8YFLogxK

U2 - 10.1002/jcsm.12181

DO - 10.1002/jcsm.12181

M3 - Article

C2 - 28150387

AN - SCOPUS:85011655240

SN - 2190-5991

VL - 8

SP - 466

EP - 474

JO - Journal of Cachexia, Sarcopenia and Muscle

JF - Journal of Cachexia, Sarcopenia and Muscle

IS - 3

ER -

Assessment of maximal handgrip strength: How many attempts are needed?

Abstract

Bibliographical note

Funding

Keywords

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