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Multicenter Study
. 2016 Dec;7(5):535-546.
doi: 10.1002/jcsm.12112. Epub 2016 Apr 12.

Reference ranges of handgrip strength from 125,462 healthy adults in 21 countries: a prospective urban rural epidemiologic (PURE) study

Darryl P Leong  1 , Koon K Teo  1 , Sumathy Rangarajan  1 , V Raman Kutty  2 , Fernando Lanas  3 , Chen Hui  4 , Xiang Quanyong  5 , Qian Zhenzhen  6 , Tang Jinhua  7 , Ismail Noorhassim  8 , Khalid F AlHabib  9 , Sarah J Moss  10 , Annika Rosengren  11 , Ayse Arzu Akalin  12 , Omar Rahman  13 , Jephat Chifamba  14 , Andrés Orlandini  15 , Rajesh Kumar  16 , Karen Yeates  17 , Rajeev Gupta  18 , Afzalhussein Yusufali  19 , Antonio Dans  20 , Álvaro Avezum  21 , Patricio Lopez-Jaramillo  22 , Paul Poirier  23 , Hosein Heidari  24 , Katarzyna Zatonska  25 , Romaina Iqbal  26 , Rasha Khatib  27 , Salim Yusuf  1
Affiliations
Multicenter Study

Reference ranges of handgrip strength from 125,462 healthy adults in 21 countries: a prospective urban rural epidemiologic (PURE) study

Darryl P Leong et al. J Cachexia Sarcopenia Muscle. 2016 Dec.

Abstract

Background: The measurement of handgrip strength (HGS) has prognostic value with respect to all-cause mortality, cardiovascular mortality and cardiovascular disease, and is an important part of the evaluation of frailty. Published reference ranges for HGS are mostly derived from Caucasian populations in high-income countries. There is a paucity of information on normative HGS values in non-Caucasian populations from low- or middle-income countries. The objective of this study was to develop reference HGS ranges for healthy adults from a broad range of ethnicities and socioeconomically diverse geographic regions.

Methods: HGS was measured using a Jamar dynamometer in 125,462 healthy adults aged 35-70 years from 21 countries in the Prospective Urban Rural Epidemiology (PURE) study.

Results: HGS values differed among individuals from different geographic regions. HGS values were highest among those from Europe/North America, lowest among those from South Asia, South East Asia and Africa, and intermediate among those from China, South America, and the Middle East. Reference ranges stratified by geographic region, age, and sex are presented. These ranges varied from a median (25th-75th percentile) 50 kg (43-56 kg) in men <40 years from Europe/North America to 18 kg (14-20 kg) in women >60 years from South East Asia. Reference ranges by ethnicity and body-mass index are also reported.

Conclusions: Individual HGS measurements should be interpreted using region/ethnic-specific reference ranges.

Keywords: handgrip strength; muscle strength; normative range; reference range; reference value.

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Figures

Figure 1
Figure 1
Average handgrip strength as a function of age. Nth = North; Sth = South.
Figure 2
Figure 2
Estimated handgrip strength (solid line) as a function of age. The dotted curves represent ±1 standard deviation, and the dashed curves represent ±2 standard deviations.
See this image and copyright information in PMC

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