PhilSPEN Online Journal of Parenteral and Enteral Nutrition

(Article 138 | POJ_0130)

Original Clinical Investigation

Measurements using the hand grip dynamometer using normal, strong, and weak states

Abstract | Introduction | Methodology | Results | Discussion | Conclusion | References | Back to Total Name and Codes page2

Submitted: | Posted:

Authors:

  • Mary Karen Woolbright MD
  • Precious Gem Calamba MD
  • Luisito O. Llido MD

Institution where research was conducted:

Clinical Nutrition Services, St. Luke’s Medical Center, Quezon City, Metro Manila, Philippines

 

ABSTRACT: Back

Background:

Hand grip strength measurements reflect muscle protein bulk and function. There is a need to have a muscle mass dynamometry figures in order to get a good guide in the range of muscle strength to determine if the muscle strength is normal, average or not. Therefore, the range of movement are determined by setting ranges within normal, average and sick or debilitated activity in the patient whether he be normal or wasted.

Objective:

There is a need to know the normal values of hand grip strength in men and women in the different age groups of Filipinos.
There is a need to appreciate the values of hand grip strengths in Filipinos when they are either sick (or malnourished) or normal and to determine if the differences could be significant. From the data gathered it is hoped to use the hand grip dynamometer as a valuable tool of nutritional status determination and follow-up

Methodology:

After undergoing the machine for testing the muscle mass dynameter patients were grouped into normal, average and sick patient groups using the different ranges from large to the small sizes per body surface area.

Results:

Males are "normal" if they had a 95% low class limits rating of 51.3 (18 years to 20 years) to 32 (in the 90 years to 99 years), for the "average" if they had 41.35 (18 to 20 years) to 31.3 (90 years to 99 years) and for the "sick" at 30.7 (18 year to 20 year) up to 14.8 (at 90 year up to 99 years). This is higher in the male category.

The females have 95% low class rating level of "normal" at 31.5 (10 year to 18 year) to 17.7 (90 year to 99 year), "average" of 29 (10 year to 18 year) to 14.3 (90 year to 99 year) and for the "sick" at 26.3 (18 year to 20 year) to 7.7 (90 year to 99 year). This is lower in the female category.

Conclusion:

The males and females now have a normal range group, average range group and the sick or debilitated group and each patient are now getting their assigned values. However there is a higher level in the different ranges compared to the females which are lower.

KEYWORDS: Human muscle mass dynamometry, normal muscle mass, average muscle mass, sick muscle mass

 

INTRODUCTION | Back

Hand grip strength measurements reflect muscle protein function and bulk function. Muscle protein bulk and function reflect the nutritional status of the patient. Thus the use of hand grip strength measurements is now considered a dynamic way of nutritional status determination especially in the area of protein reserves. There is no study on hand grip strength measurements in the Philippines specially in the area of clinical nutrition.

When makine an assessment of the nutritional status we need a simple but effective evaluation of the human muscle mass dynamometry. These are the three levels of ranges of the human forearm - from the normal range, to the average range down to that of the sick or debilitated patients. This will show whether the patient's muscle mass have the normal or average range or whether they are weak to the point of being sick or debiliated. Using these indicators will help the investigator grasp whether the muscle mass dynamometer is indicative of being normal, average or sick and thus a better assessment of the patient can be done. The development of this machine which is very affordable can now help in getting a better status of the patient's status.

METHODOLOGY | Back

Hand grip dynamometer is a machine which is used in marking whether the patient's forearm is of the normal, average and sick/debiltated status. It has a calibrated system where the muscle is being measured in terms of pounds per square inch. Statistical test is used sign continuous variables with the difference coming from two samples. T-Test is used. As a rule the human muscle dynamometer of males are higher than the muscle dynamometer of females.

RESULTS | Back

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Figure 1: Human muscle mass dynamometry machine; note the area of placement of the final meter gauge and the different areas on what to detect.

Figure 2: Regression coefficinets of the different hand grip muscle mass measures

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Regression coefficient to show normal muscle mass and strength at 53.45 95% lower class limits; regression coefficient still at normal to show 44.15 95% lower class limits; regression coefficient to show average of 31.19 95% lower class limits and regression coefficient of 95% lower class limits of sick/debilliated patients pegged at 25.24 95% lower class limits. All of these data to show that there is a definite hiearchy of levels from normal to average to sick/debiltated muscle mass of patients

Figure 3: HUMAN MUSCLE MASS DYNAMOMETRY MEASUREMENTS

1A) Age - Male

95% LCL

95% UCL

1B) Age - Female

95% LCL

95% UCL

18-19 years

51.3

55.8

18-19 years

31.5

39.4

20-30 years

48

52.3

20-30 years

29.5

31.7

30-40 years

45.7

48.4

30-40 years

27.1

29.5

40-50 years

43.4

46.2

40-50 years

24.7

27.4

50-60 years

41.2

43.7

50-60 years

23.6

25.3

60-70 years

38.6

41.3

60-70 years

21.8

23.6

70-80 years

36.4

39.5

70-80 years

20.4

22.4

80-90 years

34.3

36.8

80-90 years

19.2

20.8

90-99 years

30.2

34.7

90-99 years

17.7

18.6

Normal muscle mass dynamometer

2A) Age - Male

95% LCL

95% UCL

2B) Age - Female

95% LCL

95% UCP

18-19 years

43.23

46.96

18-19 years

29

35.6

20-30 years

41.1

43.9

20-30 years

25.7

27.3

30-40 years

38.96

41.43

30-40 years

24.6

25.9

50-60 years

37.76

39.56

50-60 years

23.53

24.7

60-70 years

35.56

37.83

60-70 years

22.1

23.7

70-80 years

33.7

35.86

70-80 years

20.9

22.3

80-90 years

31

33.9

80-90 years

19.3

21.06

90-99 years

26.5

31.43

90-99 years

14.3

18.3

Average muscle mass dynamometer

3A) Sick Age - Male

95% LCL

95% UCL

3B) Sick Age - Female 

95% LCL

95% UCL

18-19 years

30.7

44.2

18-19 years

26.3

42

20-30 years

26.9

29.5

20-30 years

18.2

23

30-40 years

23.8

28.5

30-40 years

16.7

18.6

40-50 years

22.9

24.5

40-50 years

15.9

17.4

50-60 years

21.4

23.7

50-60 years

13.9

16

60-70 years

19.91

22.9

60-70 years

12.6

14.6

70-80 years

16.7

20.5

70-80 years

11

13.1

90-99 years

14.8

16.7

90-99 years

7.7

10.7

Sick or debiltated muscle mass dynamometer

.

DISCUSSION: | Back

Males have "normal" dynamometer readings if they had a 95% low class limits rating of 51.3 (18 years to 19 years) to 32 (in the 90 years to 99 years), It is a big gap from 51.3 to 32 in terms of the muscle mass readings. For the male "average" dynamometer readings, they have a 95% lower class limit rating of 41.35 (18 to 19 years) whiich goes down to 31.3 (90 years to 99 years) in terms of its 95% lower class limits. For the "sick" 95% lower class limits set at 30.7 setting at (18 year to 20 year) this goes down to 14.8 (at 90 year up to 99 years). Males have a higher level of dynamometer readings compared to females. Thus from a start of high "normal" of 51.3, its "average" of 41.35 down to the "sick" 30.7, it goes to the low normal of 32, to the average of 31.3 to the areas of the sick of 14.8.

The females have 95% low class limits rating level of "normal" at 31.5 (10 year to 18 year) and it goes down to 17.7 (90 year to 99 year). The female "average" of 29 at a 95% lower class limits rating (10 year to 18 year) goes down to 14.3 (90 year to 99 year). For the "sick" the 95% lower class limits of 26.3 (18 year to 20 year) goes down to 7.7 (90 year to 99 year). Thus we also note that from normal of 31.5 it goes down to 29 and finally to 26.3 units. However if we look at the 95% lower class limits from the lower normal of 17.7, it goes down to 14.3 and finally to 7.7.

 

CONCLUSION: | Back

The normal, average and sick human dynamometer readings of males are higher compared to the normal, average and sick human dynamometer readings in females. Each can be easily taken using these readings with very acceptable rates or interpretation of readings.

 

REFERENCES: | Back

  1. Anne Wind, Tim Takken , (march 2009) Is grip Strength predictor of muscle strength among young adults (5-6)
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Abstract | Introduction | Methodology | Results | Discussion | References | Back to Total Name and Codes page2