European Journal of Cardiovascular Medicine

Handgrip strength (HGS) is a reliable measure of skeletal muscle health and physical capacity in. Low HGS is associated with multifactorial metabolic and behavioural processes, including physical inactivity, nutritional and hormonal derangements, reduced metabolism, and disease in old age group. Metabolic syndrome is a cluster of three–five metabolic dysfunctions, including insulin resistance, dyslipidaemia, elevated blood pressure, and abdominal obesity[1].  Hand grip strength has predictive potential of nutritional status and short-term, long-term mortality and morbidity for many diseases. It is often used as a specific test in medicine for a diverse purpose, including diagnosis of diseases, evaluating and comparing treatments, assessing progression of treatment and providing feedback during the rehabilitation process. Impaired Hand grip strength can cause significant functional limitations leading to decreased basic and instrumental activities of daily living, thereby diminishing quality of life of an individual. But the hand grip muscle strength is influenced by various factors, that mainly are fatigue, time of the day, age, gender, nutritional status, restricted motion, anthropometric 

parameters and pain[2]. Sarcopenia, defined as the presence of low muscle mass and low function, is prevalent in an estimated 5-13% of 60–70-year-olds and 11-50% of men and women over 80 years old and incurs considerable healthcare costs through its association with disability. Low grip strength, a correlate of general muscle strength, has been proposed as a key indicator of sarcopenia and lower grip strength has also been independently associated with important health outcomes such as an increased risk of institutionalisation and death[3]. Sedentary people who were not actively participating in sports have demonstrated significantly lower HSG compared to physically active people that involved in regular sports activity such as cricket, hockey, tennis, basketball, handball, etc. Therefore, HGS can be used to indicate the sedentary nature of a population, and it would help to predict their potential risk of developing non-communicable diseases such as Myocardial infarction and stroke[4].

Hand and forearm muscles are important in grip strength. Grip strength is often used as an indicator of overall physical strength, hand and forearm muscle performances. Hand Grip Strength access the muscular strength of an individual. The power of hand grip is a result of forceful flexion of all finger joints with maximum voluntary force that subject is able to exert under normal bio kinetic conditions. Hand Grip Strength has evolved as an important tool for the assessment of the nutritional status. It is being considered as a reliable marker of the muscle quality 9-11 . Research suggests that there are strong correlations between Grip Strength and Body Mass Index. It is widely accepted that grip strength provides an objective index of the functional integrity of the upper extremity. During gripping activities, muscle of the flexor mechanism in hand and forearm creates grip strength while the extensors of the forearm stabilize the wrist. Grip strength can be measured quantitatively using a hand dynamometer. Hand dynamometer is the most valid and reliable tool to measure grip strength. In present study hand dynamometer is used as an outcome measure for evaluation of grip strength [4]. The present study conducted find relationship between Body Mass Index and Handgrip endurance in student age group aged between 18-21 years

The present study is conducted to find relationship between BMI and Handgrip endurance. This study included 90 subjects, out of 90, 45 students were boys and remaining were girls. All the subjects aged between 18-21, who belongs to MBBS students of our institution.  The study design was ethically approved by the institutional ethical committee. An informed consent of the volunteers was taken on an approved proforma. All the participants were selected on the basis of inclusion and exclusion criteria. The only healthy students were included in study. The students who were on medication or suffering from any ill-health were excluded from study. The students especially upper limb fractured or with limb deformity were excluded and the student with disorders like cardiovascular and respiratory were excluded. The subjects who had a BMI below 30 and those with no history of smoking or alcoholism were included in the study.

Measuring of Height and Weight

The height was measured with stadiometer, without footwear and adjusted to nearing centimetre. We have used standardized weighing scale for measuring of weight of subjects in standing position and adjusted to nearing 0.1kg. We have used Quetlet’s index for calculating subjects Body Mass Index (BMI). We have categorised the subjects into 3 groups, that are underweight, Normal weight and overweight. In underweight group we have included the subjects with a BMI of less than 18.5(kg/m2), the subjects with a BMI which was between 18.5 to 24.99 (kg/m2) were classified as the normal weight group and the subjects BMI of between 25 to 29.99 (kg/m2) were classified as overweight[5,6].

Measurement of the hand grip Strength and endurance

In present study we have used a handgrip dynamometer to measure the handgrip strength and endurance of the dominant hand. The participants were advised to keep their hand on a table with the angle in the elbow being maintained at 90 degrees and they were asked to press the handle of the dynamometer with maximum strength. We have taken three readings were taken with a gap of 10 minutes and we have recorded and analysed the maximum reading was taken for analysis. We followed standard protocol for measuring hand grip and endurance according to previous studies [7,8]. All the data were recorded and expressed in Mean +SD, SPSS software was used to analyses data. The handgrip strength and endurance were correlated with the BMI and the body fat percentage. The significance level was set at p < 0.05 and it was considered as significant

In present study we have calculated the BMI after measuring weight and height of subjects. In present study the average male subjects in underweight group was   17.34+1.56kg and in female it was 18.16+1.14kg, the average of male subjects in normal weight group was 23.42+2.09kg and in female it was 21.16+1.85kg, the average of male subjects in over weight group was 26.92+2.26kg and in female it was 28.23+1.87kg. The P-value in both male and female, between all three groups was <0.001(Table1).

In case of Handgrip Strength (Kg) in present study the average male subjects in underweight group was   32.26+5.16 and in female it was 26.82+4.15, the average of male subjects in normal weight group was 34.12+3.42 and in female it was 28.24+2.16, the average of male subjects in over weight group was 30.96+2.86 and in female it was 23.84+5.06. The P-value in both male and female, between all three groups was >0.05(Table1).

In case of Handgrip endurance (Sec) in present study the average male subjects in underweight group was   136.62+32.24 and in female it was 117.46+25.86, the average of male subjects in normal weight group was 215.56+42.16 and in female it was 152.64+37.15, the average of male subjects in over weight group was 115.47+38.32 and in female it was 102.94+27.42. The P-value in both male and female, between all three groups was <0.001(Table1).

Table 1. Showing the values of BMI, Handgrip Strength(kg) and Handgrip endurance(Sec).

The decreased muscle strength in underweight can be explained on the basis of the energy deficiency. There are studies which have stated that the muscles of obese persons will have a fatty infiltration and a change in the distribution of the type I and type II muscle fibres, which will alter the muscle strength and endurance, whereas the status of the muscle strength and endurance in the overweight population has yet to be clearly understood. The nutritional status can influence the muscle quality and so, the muscle strength. The association between the muscle strength and underweight and the muscle strength and overweight were studied separately by many researchers, but very few studies have investigated the longitudinal assessment of the BMI with the muscle strength and muscle endurance in various BMI ranges[5]. In present study we have calculated the BMI after measuring weight and height of subjects. There was significant difference between the norma, underweight and over weight and the P-value in both male and female, between all three groups was <0.001. In present study  Handgrip Strength (Kg) was not shown significance difference between three groups. The P-value in both male and female, between all three groups was >0.05. In case of Handgrip endurance (Sec) in present study the average male subjects in underweight group was   136.62+32.24 and in female it was 117.46+25.86, the average of male subjects in normal weight group was 215.56+42.16 and in female it was 152.64+37.15, the average of male subjects in over weight group was 115.47+38.32 and in female it was 102.94+27.42. The P-value in both male and female, between all three groups was <0.001.

Our present study result in accordance with the study of Lad UP[5] in their study in males, the handgrip endurance was better in normal weight individuals, but among the females, the underweight females had a better handgrip endurance, but the difference was statistically insignificant (p>0.05). In both males and females, there was a statistically significant difference in the handgrip endurance, with the maximum grip endurance in the normal weight group and the minimum grip endurance in the overweight group (p< 0.05). The correlation between the BMI, the body fat percentage and the handgrip endurance was complex and different for males and females.

In study of Dhananjaya JR[9] result shows that there was a significant correlation between HGE and overall BMI, with P = 0.001 which is highly significant. There was a highly significant difference in HGS between male and female groups, P < 0.0001. They also noted that BMI and HGS are negatively correlated among normal BMI male participants and weakly 

negatively correlated among obese males. In overweight females, the HGS and BMI were also weakly negatively correlated and had no correlation in normal and obese female participants. HGE was weakly negatively correlated among overweight and obese males. Our study results also in corelation with this study.

A cross-sectional study conducted by Shozi S[10] on 688 (198 men; 490 women) adults aged 35–70 years. Body mass index (BMI) and waist circumference were used as measures of body composition. Spearman correlation coefficients determined the relationship between PA, BMI and HGS. In the study, 22% and 26%, respectively, were overweight and obese with women being more overweight and obese compared to men. Sixty percent of the participants met the recommended 150 min or more of moderate to vigorous PA (MVPA) per week. Handgrip strength of the participants in the study was weaker than the published norms. Handgrip strength significantly (p < 0.05) differed by age. A significant positive association was found between HGS and BMI. Age negatively (r = –0.12; p = 0.001) correlated with MVPA per week. In study of Jibi Paul[11] there is a positive association and strong correlation between Body Mass Index and Hand Grip Strength between the Groups at (r = 0.523) & (P ≤ 0.05). In study of Prakash, V[4] observed While in females there was statistically non-significant positive correlation between HGS and BMI in normal females. Statistically significant positive correlation was observed in overweight and obese females. When HE was correlated with BMI, it was observed that there was non-significant negative correlation in males.

The present study results may be helpful to understand the relation between BMI and handgrip strength and endurance. Handgrip may increase with weight and BMI. Physical fitness is very much essential for maintaining a healthy lifestyle. Handgrip strength and endurance are important parameters to assess muscular strength of an individual. As the weight increases muscle strength and endurance time also decreases as shown by our study. BMI is considered as a useful tool to measure the degree of overweight, but it will not indicate the factors causing the increase in weight.

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https://www.doi.org/10.7860/JCDR/2022/55381/16897.

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