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

Research output: Contribution to journalArticleAcademicpeer-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 languageEnglish
Pages (from-to)466-474
JournalJournal of Cachexia, Sarcopenia and Muscle
Volume8
Issue number3
DOIs
Publication statusPublished - Jun 2017

Cite this

Reijnierse, Esmee M. ; de Jong, Nynke ; Trappenburg, Marijke C. ; Blauw, Gerard Jan ; Butler-Browne, Gillian ; Gapeyeva, Helena ; Hogrel, Jean Yves ; Mcphee, Jamie S. ; Narici, Marco V. ; Sipilä, Sarianna ; Stenroth, Lauri ; van Lummel, Rob C. ; Pijnappels, Mirjam ; Meskers, Carel G M ; Maier, Andrea B. / Assessment of maximal handgrip strength : How many attempts are needed?. In: Journal of Cachexia, Sarcopenia and Muscle. 2017 ; Vol. 8, No. 3. pp. 466-474.
@article{657d7947818a4ef395c76e4cf52712ed,
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 = "Aged, Geriatric assessment, Muscle strength, Reproducibility of Results, Sarcopenia",
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.}",
year = "2017",
month = "6",
doi = "10.1002/jcsm.12181",
language = "English",
volume = "8",
pages = "466--474",
journal = "Journal of Cachexia, Sarcopenia and Muscle",
issn = "2190-5991",
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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

Assessment of maximal handgrip strength : How many attempts are needed? / Reijnierse, Esmee M.; de Jong, Nynke; Trappenburg, Marijke C.; Blauw, Gerard Jan; Butler-Browne, Gillian; Gapeyeva, Helena; Hogrel, Jean Yves; Mcphee, Jamie S.; Narici, Marco V.; Sipilä, Sarianna; Stenroth, Lauri; van Lummel, Rob C.; Pijnappels, Mirjam; Meskers, Carel G M; Maier, Andrea B.

In: Journal of Cachexia, Sarcopenia and Muscle, Vol. 8, No. 3, 06.2017, p. 466-474.

Research output: Contribution to journalArticleAcademicpeer-review

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 - Aged

KW - Geriatric assessment

KW - Muscle strength

KW - Reproducibility of Results

KW - Sarcopenia

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U2 - 10.1002/jcsm.12181

DO - 10.1002/jcsm.12181

M3 - Article

VL - 8

SP - 466

EP - 474

JO - Journal of Cachexia, Sarcopenia and Muscle

JF - Journal of Cachexia, Sarcopenia and Muscle

SN - 2190-5991

IS - 3

ER -