Elsevier

Physiotherapy

Volume 92, Issue 1, March 2006, Pages 11-15
Physiotherapy

Review
Reference values for adult grip strength measured with a Jamar dynamometer: a descriptive meta-analysis

https://doi.org/10.1016/j.physio.2005.05.003Get rights and content

Abstract

The purpose of this meta-analysis was to consolidate the results of studies presenting normative values for grip strength obtained with the Jamar dynamometer in accordance with the recommendations of the American Society of Hand Therapists. Relevant data from 12 sources (3317 subjects) were employed. Means and 95% confidence intervals are presented for the left and right sides of men and women in 12 age groups (20–24, 25–29, 30–34, 35–39, 40–44, 45–49, 50–54, 55–59, 60–64, 65–69, 70–74, 75+ years). The consolidated grip strength reference values offer a better standard for comparison than provided by any single study alone. Limitations in the meta-analysis notwithstanding, the lower limit of the 95% confidence interval can serve as a reasonable threshold for establishing grip strength impairment among adults.

Introduction

Reference values are essential if informed decisions are to be made about the normality of an individual's status relative to the population [1]. Such values are particularly important when it comes to hand grip dynamometry, as grip strength is used not only to describe the status of the hand but also to characterise overall upper extremity strength [2], [3]. The American Society of Hand Therapists (ASHT) has recommended that grip strength should be measured using the Jamar dynamometer with its handle in the second position [4]. The ASHT also recommended that tested individuals should be seated with their shoulders adducted, their elbows flexed 90°, and their forearms in neutral [4]. Although many published values have not been acquired under these conditions, some investigators have adhered to ASHT recommendations. Mathiowetz et al. were probably the first [5], followed by several other groups [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16]. While useful, the values reported by investigators complying with ASHT recommendations have been procured from relatively small samples of subjects residing in specific geographic regions. A better sense of normal grip strength might be derived from measurements obtained from a larger number of subjects dwelling in different areas. The purpose of this meta-analysis, therefore, was to consolidate normative data obtained in accordance with ASHT recommendations in multinational settings.

Section snippets

Materials and methods

A search of the MEDLINE, Cumulative Index of Nursing and Allied Health, and EMBASE databases (1982–2004) was conducted by the first author to identify articles written in English that reported normative values for grip strength. The terms ‘hand’, ‘grip’, ‘strength’, ‘dynamometer’, ‘Jamar’, ‘norms’ and ‘reference values’ were used in the searches. Apparently relevant articles were obtained and their reference lists were scanned for other potentially relevant articles. All articles were reviewed

Results

Data from 12 sources were used in the analysis (Table 1) [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16]. The total number of subjects whose data contributed was 3317. The number of relevant subjects per source ranged from 12 to 1202 (Table 1). The number of subjects per age group ranged from 82 to 217 for males and from 116 to 361 for females (Table 2). The data from the different studies were shown for each side of each age group of each gender to be homogeneous (Q = 

Discussion

Although numerous studies of hand grip strength have been published, many summarise data obtained with instrumentation, procedures or measures other than those recommended by the ASHT [4] and used by Mathiowetz et al. [5]. The exclusion of such studies [18], [19], [20], [21], [22], while necessitated by the variability associated with different methods, limited the number of studies we were willing to include in our analysis. There remained, nevertheless, 12 studies that could be consolidated

References (24)

  • B.P. Horowitz et al.

    Grip strength: collection of normative data with community dwelling elders

    Phys Occup Ther Geriatr

    (1997)
  • P. Brennan et al.

    Grip strength norms for elderly women

    Percept Motor Skills

    (2004)
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