Background: An accurate, quantifiable assessment of hand grip strength (HGS) can predict overall strength and health with a good predictor for identifying populations at higher risk for any medical conditions like rheumatoid arthritis, neuromuscular diseases and stroke that helps clinicians establish realistic treatment goals and provides treatment outcome data. The purpose of the study is to determine the percentile scores of HGS of healthy adult individuals of various age groups using Jamar dynamometer and modified sphygmomanometer.

Methods: This descriptive study measures HGS using Jamar dynamometer and modified sphygmomanometer obtained from one hundred twenty healthy participants 20 years old and above. Comparative analyses of the 2 apparatuses were conducted using One-Way ANOVA. The reference intervals at different percentiles were calculated using the Clinical and Laboratory Standard Institute (CLSI) guidelines.

Results: Grip strength (GS) using Jamar dynamometer (JD) and modified sphygmomanometer (MS) among younger (20-29 years old) participants, the 50th percentile (Q2) JD score was 28.29 kg with an equivalent MS score of 161.38 mmHg, were significantly higher compared to those across older age groups especially among the ≥70 years old with a JD Q2 score of 16.74 kg and MS Q2 score of 101.33 mmHg. These findings suggest that HGS decreases with increasing age.

Conclusion: Scores obtained from this study can serve as preliminary baseline values or guide for interpreting GS measurements.

Keywords: Grip strength; Dynamometer; Sphygmomanometer

1. Lusardi MM, Bohannon RW. Hand Grip Strength: Comparability of Measurements Obtained with a Jamar Dynamometer and a Modified Sphygmomanometer. Journal of Hand Therapy 1991 Jul 1;4(3):117-122.
2. Hamilton GF, McDonald C, Chenier TC. Measurement of Grip Strength: Validity and Reliability of the Sphygmomanometer and Jamar Grip Dynamometer. J Orthop Sports Phys Ther 1992;16(5):215-219.
3. Benton MJ, Spicher JM, Silva-Smith AL. Validity and Reliability of Handgrip Dynamometer in Older Adults: A Comparison of Two Widely Used Dynamometers. PLoS One 2021 Jun 21;17(6):e0270132. Available from: https://doi.org/10.1371/journal. pone.0270132.
4. Sousa-Santos AR, Amaral TF. Differences in handgrip strength protocols to identify sarcopenia and frailty-A systematic review. BMC Geriatr 2017 Oct 16;17(1):238.
5. Ugurlu Ü, Özdogan H. Conversion of grip strength scores between Jamar dynamometer and a modified sphygmomanometer in patients with rheumatoid arthritis. Isokinetics and Exercise Science 2013 Sep 12;21(4):263-272.
6. Flood-Joy M, Mathiowetz V. Grip-strength measurement: A comparison of three Jamar dynamometers. Occup Ther J Res. 1987;7(4):235-243.
7. Sheehan NJ, Sheldon F, Marks D. Grip strength and torquometry in the assessment of hand function in patients with rheumatoid arthritis. Br J Rheumatol 1983 Aug;22(3):158-164.
8. Lundeberg T, Abrahamson P, Haker E. A comparative study of continuous ultrasound, placebo ultrasound, and rest in epicondylagia. Scand J Rehabil Med 1988;20(3):99-101.
9. Grindulis KA, Calverley M. Grip strength: Peak or sustained pressure in rheumatoid arthritis?. J Chron Dis 1983;36(12):855-858.
10. Helewa A, Goldsmith CH, Smythe HA. Patient, observer and instrument variation in the measurement of strength of shoulder abductor muscles in patients with rheumatoid arthritis using a modified sphygmomanometer. J Rheumatol 1986 Dec;13(6):1044-1049.
11. Rice CL, Cunningham DA, Paterson DH, Rechnitzer PA. Strength in an elderly population. Arch Phys Med Rehabil 1989 May;70(5):391-397.
12. Chandrasekaran B, Ghosh A, Prasad C, Krishnan K, Chandrasharma B. Age and Anthropometric Traits Predict Handgrip Strength in Healthy Normals. J Hand Microsurg 2010 Dec;2(2):58–61.
13. Martins JC, Aguiar LT, Lara EM, Teixeira-Salmela LF, Faria CD. Assessment of grip strength with the modified sphygmomanometer test: association between upper limb global strength and motor function. Braz J Phys Ther 2015 Nov-Dec;19(6):498–506.
14. Peolsson A, Hedlund R, Oberg B. Intra- and Inter-tester reliability and reference values for hand strength. J Rehab Med 2001 Jan;33(1):36-41.
15. Yahin A, Moeliono MA, Prananta MS. Handgrip strength prediction formula using aneroid sphygmomanometer in elderly. IJIHS 2016;4(2):47-55.
16. Tsang RC. Reference values for 6-minute walk test and hand grip strength in healthy Hong Kong Chinese adults. Hong Kong Physiother J 2005 Jan;23:6–12.
17. Kamarul T, Ahmad TS, Loh WY. Hand grip strength in the adult Malaysian population. J Orthop Surg (Hong Kong) 2006 Aug;14(2):172–177.
18. Daniel WW, Cross C. Biostatistics: a foundation for analysis in the health sciences. 10th ed. United States of America: Wiley; 2013. 447-454 p.
19. Sasse EA, Doumas BT, Miller WG, D’Orazio P, Eckfeldt JH, Evans SA, et al. How to define and determine reference
20. intervals in the clinical laboratory. 2nd ed. Pennsylvania: Clinical and Laboratory Standard Institute; 2000. 4 p.
21. Horowitz GL, Altaie S, Boyd JC, Ceriotti F, Garg U, Horn P, et al. Defining, establishing, and verifying reference interval in the clinical laboratory. 3rd ed. Pennsylvania: Clinical and Laboratory Standard Institute; 2008. 26 p.
22. Günther CM, Bürger A, Rickert M, Crispin A, Schulz CU. Grip strength in healthy Caucasian adults: reference values. J Hand Surg Am 2008 Apr;33(4):558–565.
23. Hanten WP, Chen WY, Austin AA, Brooks RE, Carter HC, Law CA, et al. Maximum grip strength in normal subjects from 20 to 64 years of age. J Hand Ther 1999 Jul-Sep;12(3):193–200.
24. Desrosiers J, Bravo G, Herbert R, Dutil E. Normative data for the grip strength of elderly men and women. Am J Occup Ther 1995 Jul-Aug;49(7):637–644.
25. Fess EE, Moran CA. Clinical Assessment Recommendations. 2nd ed. United States of America: American Society of Hand Therapists; 1992. 41–45 p.
26. Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S. Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil 1985 Feb;66(2):69–74.
27. Kjerland RN. Age and sex differences in performance in motility and strength tests. Proc Iowa Acad Sci 1953;60(1):519–523.
28. Kellor M, Frost J, Silberberg N, Iversen I, Cummings R. Hand strength and dexterity. Am J Occup Ther 1971 Mar;25(2):77–83.
29. Schmidt RT, Toews JV. Grip strength as measured by the Jamar dynamometer. Arch Phys Med Rehabil 1970 Jun;51(6):321–327.
30. Rantanen T, Guralnik JM, Foley D, Masaki K, Leveille S, Curb JD, et al. Midlife hand-grip strength as a predictor of old age disability. JAMA 1999 Feb 10; 281(6):558–560.
31. Kallman DA, Plato CC, Tobin JD. The role of muscle loss in the age-related decline of grip strength: cross-sectional and longitudinal perspectives. J Gerontol 1990 May;45(3):M82–88.
32. Snih SA, Markides KS, Ray L, Ostir GV, Goodwin JS. Handgrip strength and mortality in older Mexican Americans. J Am Geriatr Soc 2002 Jul;50(7):1250–1256.
33. Syddall H, Cooper C, Martin F, Briggs R, Sayer AA. Is grip strength a useful single marker of frailty?. Age Ageing 2003 Nov;32(6):650–656.