Grip It and Get Healthy: Why Hand Strength Could Be Your New Vital Sign

Hand grip strength (HGS) might soon be joining the ranks of traditional vital signs like temperature and blood pressure. A new study published in the Journal of Health, Population, and Nutrition suggests that measuring your grip can offer valuable insights into your overall health and even predict future health risks. Why is HGS such a powerful indicator? It's a simple way to assess muscle function and strength, which is especially crucial for older adults. Low HGS has been linked to various chronic diseases like diabetes, heart disease, and even cancer. omes.

Key points

Motivation: Traditional vital signs offer limited insights into overall health. This review proposes hand grip strength (HGS) as a new vital sign to assess muscle function, physical capability, and potential health risks.

Background:

• HGS is a reliable and non-invasive measure of muscle strength, particularly relevant for the aging population.

• Low HGS correlates with various chronic diseases like type 2 diabetes, cardiovascular disease, and sarcopenia.

• Existing tools like body mass index and oxygen saturation highlight the value of additional simple measurements.

Argument for HGS as a Vital Sign:

• Comprehensive health assessment: HGS complements traditional vital signs by providing insights into musculoskeletal health and overall strength.

• Early disease detection: Low HGS can indicate potential health issues like chronic diseases before symptoms emerge, enabling early intervention.

• Predictive value: HGS can predict adverse health outcomes like disability, hospitalization, and mortality, aiding in risk stratification and preventive strategies.

• Serial measurements: Regular HGS assessments can track progress in muscle strength and patient engagement in managing their health.

• Patient engagement: HGS measurement empowers individuals to monitor their physical well-being, promoting healthy lifestyle choices and adherence to medical advice.

• Cost-effective and non-invasive: HGS is convenient and affordable to measure, making it practical for integration into routine clinical practice.

• Diverse applications: HGS is useful across age groups and genders, from assessing older adults' health to monitoring progress in rehabilitation settings.

Overall:

This review argues that HGS possesses unique features crucial for individual health: comprehensive assessment, early disease detection, predictive value, serial measurement potential, patient engagement, cost-effectiveness, and diverse applications. Including HGS as a vital sign alongside traditional measurements could provide a more holistic understanding of individual health, enabling earlier interventions, improved prognoses, and preventive strategies.

Hand grip strength (HGS) plays a pivotal role in evaluating muscle function and overall physical capability, especially in the context of the aging population. This article delves into the intricate relationship between HGS and various health parameters, including morbidity and mortality. Through an extensive literature search on PubMed, Scopus, and Google Scholar, the study scrutinised the existing evidence to establish HGS as a crucial biomarker of health. Our review encompasses the interplay between HGS and conditions such as Type 2 diabetes, cardiovascular disease, stroke, chronic kidney and liver disease, various cancers, sarcopenia, and fragility fractures.

Background and Aims

In the realm of vital signs, traditionally focused on parameters like pulse, blood pressure, temperature, and respiratory rate, there's a growing discourse on incorporating additional metrics. Beyond the well-established indices, musculoskeletal strength indicators, specifically HGS, are gaining prominence. The non-invasive nature of these measurements, coupled with the surge in interest due to the COVID-19 pandemic, positions HGS as a fundamental metric in assessing muscle function and physical capability, particularly in the ageing demographic.

Methods

methodology involved a meticulous literature search conducted between August 10 and 30, 2023, employing keywords such as 'hand grip strength,'' muscle' '' 'sarcopenia,' 'osteosarcopenia,' 'health biomarker,' 'osteoporosis,' and 'frailty.' The synthesis of empirical evidence forms the basis for our proposal: positioning HGS as a new vital sign in clinical practice.

Results and Discussion

Handgrip Strength Measurement

TEST

HGS is conveniently measured using a hand-held dynamometer (HHD), with Jamar’s hand-held hydraulic dynamometer being a notable example. While isokinetic dynamometers offer precision, their cost and bulkiness limit practicality. The HHD, commonly used, provides an isometric strength measure, indicative of overall strength. Testing in different positions captures distinct muscle groups, influencing the assessment of lower body and core strength.

PROCEDURE FOR PERFORMING HANDGRIP STRENGTH

This study adhered to established protocols, such as those of the American Society of Hand Therapists (ASHT) and Southampton University. Calibration, especially with the Jamar dynamometer, significantly enhances reliability, making it a preferred choice.

DOMINANT HGS

Measuring strength in the dominant hand provides insights into tasks requiring precision or force. This information is valuable in understanding specific strengths used in daily activities.

RELATIVE HGS

Adjusting HGS relative to an individual's body size, computed as absolute HGS divided by BMI, offers a more nuanced understanding. Studies suggest its advantage in predicting cardiovascular biomarkers and metabolic disorders.

Normative Values of HGS

HGS values vary globally, dependent on ethnicity, gender, age, and nutritional status. Reference values from countries like Great Britain, Australia, Canada, Korea, Germany, and Japan provide a foundation. However, caution is warranted in applying these values universally.

Cut-offs of Hand Grip Strength: Guidelines and Selected Studies

While some guidelines provide cut points for muscle weakness, achieving standardized, ethnic-, sex-, and age-specific categories for muscle weakness would enhance clinical relevance. Existing guidelines predominantly hail from high-income countries, necessitating a more inclusive approach.

Exercises to Strengthen Your Grip and Give You a Hand Up on Health

A firm handshake, the ability to open a stubborn jar, and the confidence to tackle any physical challenge—strong grip strength comes in handy for more than just impressive feats. It's a key indicator of overall health and muscle function, especially as we age. The good news is that you don't need fancy equipment or a gym membership to improve your grip. Here are some simple exercises you can do anytime, anywhere to build hand and forearm strength:

Squeeze it out.

• Stress ball: These squishy spheres are a classic for a reason. Squeeze, hold, and release repeatedly to work your entire hand and forearm muscles. Stress ball exercise for grip strength

• Tennis ball: Similar to a stress ball, but with a slightly textured surface for added grip challenge. Squeeze it in different ways, focusing on the palm, fingers, and thumbs.

Hang in there:

• Pull-up bar: The ultimate grip test! If you can't do a full pull-up, start with hanging for increasing lengths of time.

• Doorway hangs: Find a sturdy doorway and grip the frame at shoulder height. Hang for as long as you can comfortably, or try hanging with just one arm for an extra challenge.

Grip and grab:

• Farmer's carry: Grab two heavy objects, like dumbbells or water jugs, and walk for a set distance. This works your forearms, grip, and core stability.

• Towel wring: Take a dry towel and twist it as tightly as you can in both directions. This is a great way to target the muscles in your fingers and forearms.

Bonus tips:

• Mix it up: Don't stick to the same exercises every day. Keep your muscles challenged by trying different variations and combinations.

• Listen to your body: Don't push yourself too hard, especially if you're new to grip training. Start with lighter weights or shorter holding times and gradually increase as you get stronger.

• Warm-up and cool down: Just like any other workout, it's important to warm up your hands and forearms before exercising and cool down afterwards to prevent injury.

Here are some additional exercises you can try if you're looking for more variety:

• Rock climbing: A fun and challenging activity that works your entire body, including your grip strength.

• Playing guitar or piano: These instruments require strong finger dexterity and hand strength, making them a great way to improve your grip while enjoying a hobby.

• Grip trainers: These specialized tools come in various forms and offer targeted grip training. Consult a fitness expert to choose the right one for you.

Conclusion

Our comprehensive review establishes HGS as a vital sign with far-reaching implications for health assessment. From the intricacies of measurement to normative values and cut-offs, this article provides a holistic understanding of HGS. Embracing HGS as a new vital sign promises to revolutionize clinical evaluations, offering valuable insights into overall health and potential issues throughout the lifespan.

Reference Article

Vaishya, R., Misra, A., Vaish, A. et al. Hand grip strength as a proposed new vital sign of health: a narrative review of evidences. J Health Popul Nutr 43, 7 (2024). https://doi.org/10.1186/s41043-024-00500-y

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