Handgrip Strength Could Be a Simple Way to Predict Fall Risk

Elizabeth Millard

June 10, 2020

Handgrip strength might be an effective and easy way to assess the risk for falls in older people, according to results from a new study.

"When we think of falls, our first thought is often about muscle strength in the lower limbs, but that is not always easy to determine in a nonspecialized clinical setting," said Silvia Neri, a PhD candidate at the University of Brasilia in Brazil.

"Handgrip strength, however, can be a first line of assessment and can be done in any setting," she told Medscape Medical News.

It can provide an indication that treatment or physical therapy — as well as more extensive assessment — is needed, said Neri, who was scheduled to present the research at the cancelled American College of Sports Medicine 2020 Annual Meeting.

Falls are the leading cause of fatal and nonfatal injuries among older people, and women are affected disproportionately, she reported. When strength affects proprioception, it can cause several systems — vestibular, visual, and muscular — to delay response times, potentially resulting in a more serious injury.

The study cohort involved 204 women, with a median age of 68 years, who were assessed for handgrip strength using a Jamar hand grip dynamometer at an initial appointment and then 18 months later. The measurement, adjusted for body mass index, was used for the clinical determination of muscle weakness. Participants were also stratified by postural balance.

During the follow-up period, 27% of participants experienced at least one fall.

Risk for falls was a significant 2.73 times higher in women who had poor handgrip strength than in those who had normal handgrip strength. The risk was even greater in women with impaired balance.

Easy Measure, Progressive Changes

One advantage of handgrip assessment is that, unlike variables such as gait and balance, it can be standardized, said Carole Kishi, DPT, a physical therapist at Providence Saint John's Health Center in Santa Monica, California. Clinicians can establish a baseline level of strength that they can then compare with subsequent assessments.

"You would be able to tell very quickly from one appointment to the next whether strength is increasing or decreasing," she told Medscape Medical News. "Most of all, you could be consistent in quantifying strength between practitioners. In fact, this might be the best way possible to get that objective measure, and it's easy to train staff on using it."

Basically, the weaker your grip, the weaker your body is overall.

Not only can handgrip strength give an indication of muscle strength, but previous research suggests it could provide insight on bone density as well.

Women with low grip strength had significantly lower bone mass density (BMD) at the spine and femoral neck than those with normal grip strength, according to a 2005 study, and men with low grip strength had lower BMD at the spine and hip. Additionally, women in that study with low grip strength were at increased risk for incident vertebral fracture.

Grip strength is an indispensable biomarker in older adults, providing insight not just on overall strength, but also as a potential indicator of poor upper limb function, malnutrition, cognitive impairment, and quality of life, a 2019 commentary explains.

"Basically, the weaker your grip, the weaker your body is overall," Kishi said. "This is such a simple tool, and after seeing this research, I'm planning on incorporating it into my own practice more often."

American College of Sports Medicine (ACSM) 2020 Annual Meeting.

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