Normative values of hand grip and pinch grip strength in older adults - A cross sectional study

Approval is obtained from Institutional Review Board and Ethics Committee .Informed consent will be obtained from all participants .

The subjects will be divided into following quota

According to age and gender

Young old (60-69 years)-60 (30 Males and 30 Females)

Middle old (70-79 years)-60 ( 30Males and 30 Females)

Older Old (80 years and above)-60 (30 Males and 30 Females)

Participants will be enrolled based on inclusion and exclusion criteria

Screening for Inclusion Criteria.

30 Second Chair Stand test

• A chair (without arm rest) will be placed against wall.

• Subject will be seated in middle of the chair with feet shoulder width apart flat on floor

• The arms will be crossed at wrist and held close to chest

• From sitting position subject will be asked to stand completely up and then sit completed down and this will be repeated for 30 seconds.

• The total number of complete chair stands will be calculated

• The functional category has following standard values for Chair

Fun (more than 15 repetitions)

Function (8-15 repetitions)

Frail (less than 8 repetitions)

Failure (Unable to perform the test.)

According to above mentioned criteria subjects who fit into Fun and

Function stage will be recruited for the study.

HAND GRIP STRENGTH

Hand grip strength of the dominant hand will be measured with Jamar Hydraulic dynamometer. The American Society of Hand Therapist suggested a standardized position for the measurement of grip strength.

• They recommended that the subject should be seated on a chair without arm rest with his straight trunk and hip knee at 90°, shoulder adducted with no rotation, elbow flexed at 90°, forearm in neutral position and wrist in 0̊-30̊ of extension and 0̊to 15̊ of ulnar deviation.

• The arm should not be supported by the chair handle.

• To measure grip strength the dynamometer should be placed in hand vertically and in line with forearm.

• The handle of the dynamometer will be adjusted to second position (3.8 apart) for all subjects.

• Subject will be asked to squeeze the handle of the dynamometer as maximally as possible and then release.

• Three readings will be taken with 60 seconds rest period in between.

• The mean of three attempts will be calculated.

PINCH GRIP STRENGTH

Pinch grip strength of the dominant hand will be measured using Bernadette and Linda (B & L) Engineering Mechanical pinch gauge.

• The American Society of Hand Therapist suggested a standardized position for the measurement of Pinch strength

• They recommended that the subject should be seated on a chair without arm rest with his straight trunk and hip knee at 90°, shoulder adducted with no rotation, elbow flexed at 90°, forearm

in neutral position and wrist in 0ÌŠ-30ÌŠ of extension and 0ÌŠto 15ÌŠ of

ulnar deviation.

• The arm should not be supported by the chair handle.

• While taking each reading the therapist will stabilize the pinch gauge.

1. Two-point pinch / tip to tip pinch: Pinch strength will be measured between tip of thumb and tip of index finger. The thumb tip will be placed in front of index finger will on pinch gauge and readings will be taken.

2. Lateral pinch / key pinch: Pinch strength will be measured between radial side of index finger and thumb. The thumb pad will be placed against the lateral aspect of the middle phalanx if index finger and readings will be taken.

3. Three-point pinch / three jaw chunks / palmar pinch: Pinch strength will be measured between pulp of thumb and pulp of index finger and middle finger. The thumb pad will be placed in front of pads of index finger and middle finger.

• Subject will be instructed to pinch as hard as possible.

• Three readings will be taken with 60 seconds rest period in between and mean will be calculated.

Data collected will be compiled on to a MS Office excel worksheet.

Descriptive statistics like frequency (n) and percentage (%) of categorical

data, mean and standard deviation of numerical data will be depicted.

Percentile wise score will be calculated for hand grip and pinch grip

strength using the following equation:

P= n/N*100

Where P is percentile score, n is number of data point below the data of

interest and N is total number of data points in the data set.

The data collected will be analyzed using MS Office excel.