International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions
Background: Muscular strength is a powerful marker of current health status and robust predictor of age-related disease and disability. Handgrip strength (HGS) using isometric dynamometry is a convenient, feasible, and widely used method of assessing muscular strength among people of all ages. While...
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2025-12-01
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| author | Grant R. Tomkinson Justin J. Lang Lukáš Rubín Ryan McGrath Bethany Gower Terry Boyle Marilyn G. Klug Alexandra J. Mayhew Henry T. Blake Francisco B. Ortega Cristina Cadenas-Sanchez Costan G. Magnussen Brooklyn J. Fraser Tetsuhiro Kidokoro Yang Liu Kaare Christensen Darryl P. Leong Mette Aadahl Edimansyah Abdin Julian Alcazar Aqeel Alenazi Bader Alqahtani Cledir De A. Amaral Thatiana L.M. Amaral Alex Andrade Fernandes Peter Axelsson Jennifer N. Baldwin Karin Bammann Aline R. Barbosa Ameline Bardo Inosha Bimali Peter Bjerregaard Martin Bobak Colin A. Boreham Klaus Bös João Carlos Bouzas Marins Joshua Burns Nadezda Capkova Lilia Castillo-Martínez Liang-Kung Chen Siu Ming Choi Rebecca K.J. Choong Susana C. Confortin Cyrus Cooper Jorge E. Correa-Bautista Amandine Cournil Grace Cruz Eling D. de Bruin José Antonio De Paz Bruno De Souza Moreira Luiz Antonio Dos Anjos María Cristina Enríquez Reyna Eduardo Ferriolli Gillian Forrester Elena Frolova Abadi K. Gebre Atef M. Ghaleb Tiffany K. Gill Yasuyuki Gondo M. Cristina Gonzalez Citlali Gonzalez Alvarez Mary K. Hannah Nicholas C. Harvey Jean-Yves Hogrel Marie-Theres Huemer Toshiko Iidaka Lewis A. Ingram Dmitri A. Jdanov Victoria L. Keevil Wolfgang Kemmler Rose Anne Kenny Dae-Yeon Kim Tracy L. Kivell Ingirid G.H. Kjær Alexander Kluttig Rumi Kozakai Danit Langer Lisbeth A. Larsen Wei-Ju Lee David A. Leon Eric Lichtenstein Bertis B. Little Roberto Alves Lourenço Rahul Malhotra Robert M. Malina Kiyoaki Matsumoto Tal Mazor-Karsenty Marnee J. McKay Sinéad McLoughlin Abhishek L. Mensegere Mostafa Mohammadian Virgilio Garcia Moreira Hiroshi Murayama Anne Murray Anita Liberalesso Neri Claudia Niessner Gabriel Núñez Othón Gabriel Olveira Suzanne G. Orchard Andrezj Pajak Chan Woong Park Julie A. Pasco Maria E. Peña Reyes Leani Souza Máximo Pereira Annette Peters Eric Tsz-Chun Poon Margareth C. Portela Jedd Pratt Robinson Ramírez-Vélez Wendy Rodríguez-García Joanne Ryan Mauricio A. San-Martín Francisco José Sánchez-Torralvo Mahnaz Saremi Arno Schmidt-Trucksäss Satoshi Seino Shamsul Azhar Shah Marc Sim Bjørn Heine Strand Mythily Subramaniam Charlotte Suetta Sophia X. Sui Jonas S. Sundarakumar Koya Suzuki Abdonas Tamosiunas Maw Pin Tan Yu Taniguchi Barbara Thorand Anna Turusheva Anne Therese Tveter Jonathan Wagner Dao Wang Stuart J. Warden Julia Wearing Shiou Liang Wee Leo D. Westbury Agnieszka Wiśniowska-Szurlej Alexander Woll Noriko Yoshimura Ruby Yu |
| author_facet | Grant R. Tomkinson Justin J. Lang Lukáš Rubín Ryan McGrath Bethany Gower Terry Boyle Marilyn G. Klug Alexandra J. Mayhew Henry T. Blake Francisco B. Ortega Cristina Cadenas-Sanchez Costan G. Magnussen Brooklyn J. Fraser Tetsuhiro Kidokoro Yang Liu Kaare Christensen Darryl P. Leong Mette Aadahl Edimansyah Abdin Julian Alcazar Aqeel Alenazi Bader Alqahtani Cledir De A. Amaral Thatiana L.M. Amaral Alex Andrade Fernandes Peter Axelsson Jennifer N. Baldwin Karin Bammann Aline R. Barbosa Ameline Bardo Inosha Bimali Peter Bjerregaard Martin Bobak Colin A. Boreham Klaus Bös João Carlos Bouzas Marins Joshua Burns Nadezda Capkova Lilia Castillo-Martínez Liang-Kung Chen Siu Ming Choi Rebecca K.J. Choong Susana C. Confortin Cyrus Cooper Jorge E. Correa-Bautista Amandine Cournil Grace Cruz Eling D. de Bruin José Antonio De Paz Bruno De Souza Moreira Luiz Antonio Dos Anjos María Cristina Enríquez Reyna Eduardo Ferriolli Gillian Forrester Elena Frolova Abadi K. Gebre Atef M. Ghaleb Tiffany K. Gill Yasuyuki Gondo M. Cristina Gonzalez Citlali Gonzalez Alvarez Mary K. Hannah Nicholas C. Harvey Jean-Yves Hogrel Marie-Theres Huemer Toshiko Iidaka Lewis A. Ingram Dmitri A. Jdanov Victoria L. Keevil Wolfgang Kemmler Rose Anne Kenny Dae-Yeon Kim Tracy L. Kivell Ingirid G.H. Kjær Alexander Kluttig Rumi Kozakai Danit Langer Lisbeth A. Larsen Wei-Ju Lee David A. Leon Eric Lichtenstein Bertis B. Little Roberto Alves Lourenço Rahul Malhotra Robert M. Malina Kiyoaki Matsumoto Tal Mazor-Karsenty Marnee J. McKay Sinéad McLoughlin Abhishek L. Mensegere Mostafa Mohammadian Virgilio Garcia Moreira Hiroshi Murayama Anne Murray Anita Liberalesso Neri Claudia Niessner Gabriel Núñez Othón Gabriel Olveira Suzanne G. Orchard Andrezj Pajak Chan Woong Park Julie A. Pasco Maria E. Peña Reyes Leani Souza Máximo Pereira Annette Peters Eric Tsz-Chun Poon Margareth C. Portela Jedd Pratt Robinson Ramírez-Vélez Wendy Rodríguez-García Joanne Ryan Mauricio A. San-Martín Francisco José Sánchez-Torralvo Mahnaz Saremi Arno Schmidt-Trucksäss Satoshi Seino Shamsul Azhar Shah Marc Sim Bjørn Heine Strand Mythily Subramaniam Charlotte Suetta Sophia X. Sui Jonas S. Sundarakumar Koya Suzuki Abdonas Tamosiunas Maw Pin Tan Yu Taniguchi Barbara Thorand Anna Turusheva Anne Therese Tveter Jonathan Wagner Dao Wang Stuart J. Warden Julia Wearing Shiou Liang Wee Leo D. Westbury Agnieszka Wiśniowska-Szurlej Alexander Woll Noriko Yoshimura Ruby Yu |
| author_sort | Grant R. Tomkinson |
| collection | DOAJ |
| description | Background: Muscular strength is a powerful marker of current health status and robust predictor of age-related disease and disability. Handgrip strength (HGS) using isometric dynamometry is a convenient, feasible, and widely used method of assessing muscular strength among people of all ages. While adult HGS norms have been published for many countries, no study has yet synthesized available data to produce international norms. The objective of this study was to generate international sex- and age-specific norms for absolute and body size-normalized HGS across the adult lifespan. Methods: Systematic searches were conducted in 6 databases/web search engines (MEDLINE, SPORTDiscus, Embase, Web of Science, CINAHL, and Google Scholar) up to December 1, 2023. We included full-text peer-reviewed observational studies that reported normative HGS data for adults aged ≥20 years by sex and age. Pseudo data were generated using Monte Carlo simulation following harmonization for methodological variation. Population-weighted Generalized Additive Models for Location, Scale, and Shape were used to develop sex- and age-specific norms for absolute HGS (kg) and HGS normalized by height (Ht, m) squared (i.e., HGS/Ht2 in kg/m2). Norms were tabulated as percentile values (5th to 95th) and visualized as smoothed percentile curves. Results: We included data from 100 unique observational studies representing 2,405,863 adults (51.9% female) aged 20 to 100+ years from 69 countries and regions tested from the year 2000 onward. On average, absolute and normalized HGS values negligibly improved throughout early adulthood, peaked from age 30–39 years (at 49.7 kg (males) and 29.7 kg (females) for absolute HGS or 16.3 kg/m2 (males) and 11.3 kg/m2 (females) for HGS/Ht2), and declined afterwards. The age-related decline in HGS accelerated from middle to late adulthood and was slightly larger for males than for females during middle adulthood. Conclusion: This study provides the world's largest and most geographically comprehensive international norms for adult HGS by sex and age. These norms have utility for global peer-comparisons, health screening, and surveillance. |
| format | Article |
| id | doaj-art-0bfdd650c56d46b4b6f8582246bb3f2e |
| institution | Kabale University |
| issn | 2095-2546 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Sport and Health Science |
| spelling | doaj-art-0bfdd650c56d46b4b6f8582246bb3f2e2025-02-12T05:30:58ZengElsevierJournal of Sport and Health Science2095-25462025-12-0114101014International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regionsGrant R. Tomkinson0Justin J. Lang1Lukáš Rubín2Ryan McGrath3Bethany Gower4Terry Boyle5Marilyn G. Klug6Alexandra J. Mayhew7Henry T. Blake8Francisco B. Ortega9Cristina Cadenas-Sanchez10Costan G. Magnussen11Brooklyn J. Fraser12Tetsuhiro Kidokoro13Yang Liu14Kaare Christensen15Darryl P. Leong16Mette Aadahl17Edimansyah Abdin18Julian Alcazar19Aqeel Alenazi20Bader Alqahtani21Cledir De A. Amaral22Thatiana L.M. Amaral23Alex Andrade Fernandes24Peter Axelsson25Jennifer N. Baldwin26Karin Bammann27Aline R. Barbosa28Ameline Bardo29Inosha Bimali30Peter Bjerregaard31Martin Bobak32Colin A. Boreham33Klaus Bös34João Carlos Bouzas Marins35Joshua Burns36Nadezda Capkova37Lilia Castillo-Martínez38Liang-Kung Chen39Siu Ming Choi40Rebecca K.J. Choong41Susana C. Confortin42Cyrus Cooper43Jorge E. Correa-Bautista44Amandine Cournil45Grace Cruz46Eling D. de Bruin47José Antonio De Paz48Bruno De Souza Moreira49Luiz Antonio Dos Anjos50María Cristina Enríquez Reyna51Eduardo Ferriolli52Gillian Forrester53Elena Frolova54Abadi K. Gebre55Atef M. Ghaleb56Tiffany K. Gill57Yasuyuki Gondo58M. Cristina Gonzalez59Citlali Gonzalez Alvarez60Mary K. Hannah61Nicholas C. Harvey62Jean-Yves Hogrel63Marie-Theres Huemer64Toshiko Iidaka65Lewis A. Ingram66Dmitri A. Jdanov67Victoria L. Keevil68Wolfgang Kemmler69Rose Anne Kenny70Dae-Yeon Kim71Tracy L. Kivell72Ingirid G.H. Kjær73Alexander Kluttig74Rumi Kozakai75Danit Langer76Lisbeth A. Larsen77Wei-Ju Lee78David A. Leon79Eric Lichtenstein80Bertis B. Little81Roberto Alves Lourenço82Rahul Malhotra83Robert M. Malina84Kiyoaki Matsumoto85Tal Mazor-Karsenty86Marnee J. McKay87Sinéad McLoughlin88Abhishek L. Mensegere89Mostafa Mohammadian90Virgilio Garcia Moreira91Hiroshi Murayama92Anne Murray93Anita Liberalesso Neri94Claudia Niessner95Gabriel Núñez Othón96Gabriel Olveira97Suzanne G. Orchard98Andrezj Pajak99Chan Woong Park100Julie A. Pasco101Maria E. Peña Reyes102Leani Souza Máximo Pereira103Annette Peters104Eric Tsz-Chun Poon105Margareth C. Portela106Jedd Pratt107Robinson Ramírez-Vélez108Wendy Rodríguez-García109Joanne Ryan110Mauricio A. San-Martín111Francisco José Sánchez-Torralvo112Mahnaz Saremi113Arno Schmidt-Trucksäss114Satoshi Seino115Shamsul Azhar Shah116Marc Sim117Bjørn Heine Strand118Mythily Subramaniam119Charlotte Suetta120Sophia X. Sui121Jonas S. Sundarakumar122Koya Suzuki123Abdonas Tamosiunas124Maw Pin Tan125Yu Taniguchi126Barbara Thorand127Anna Turusheva128Anne Therese Tveter129Jonathan Wagner130Dao Wang131Stuart J. Warden132Julia Wearing133Shiou Liang Wee134Leo D. Westbury135Agnieszka Wiśniowska-Szurlej136Alexander Woll137Noriko Yoshimura138Ruby Yu139Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia; Corresponding author.Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia; Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, CanadaDepartment of Physical Education and Sport, Faculty of Science, Humanities and Education, Technical University of Liberec, Liberec 461 17, Czech Republic; Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, Olomouc 779 00, Czech RepublicAlliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia; Healthy Aging North Dakota (HAND), North Dakota State University, Fargo, ND 58102, USA; Department of Health, Nutrition and Exercise Sciences, North Dakota State University, Fargo, ND 58108, USA; Fargo VA Healthcare System, Fargo, ND 58102, USA; Department of Geriatrics, University of North Dakota, Grand Forks, ND 58202, USAAlliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, AustraliaAustralian Centre for Precision Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, AustraliaDepartment of Population Health, University of North Dakota, Grand Forks, ND 58202, USADepartment of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, ON L8P 0A1, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, ON L8P 0A1, CanadaAlliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, AustraliaDepartment of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, ES 18071, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Granada, ES 18071, Spain; Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä 40014, FinlandDepartment of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, ES 18071, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Granada, ES 18071, Spain; Department of Cardiology, Stanford University, Stanford, CA 94305, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USAAlliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia; Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku 20520, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku 20520, FinlandAlliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, AustraliaFaculty of Sport Science, Nippon Sport Science University, Tokyo 158-8508, JapanSchool of Physical Education, Shanghai University of Sport, Shanghai 200438, China; Shanghai Research Center for Physical Fitness and Health of Children and Adolescents, Shanghai 200438, ChinaDepartment of Public Health, Epidemiology Biostatistics and Biodemography, University of Southern Denmark, Odense 5230, DenmarkThe Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON L8L 2X2, CanadaCentre for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, DenmarkResearch Division, Institute of Mental Health, SingaporeGENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Spain; Department of Geriatric and Palliative Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark; Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Spain; Grupo Mixto de Fragilidad y Envejecimiento Exitoso UCLM-SESCAM, Universidad de Castilla-La Mancha-Servicio de Salud de Castilla-La Mancha, IDISCAM, SpainDepartment of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Saudi ArabiaDepartment of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Saudi ArabiaFederal Institute of Acre, BrazilFederal University of Acre, BrazilInstituto Federal de Educação, Ciência e Tecnologia de Minas Gerais—Campus Ipatinga, BrazilDepartment of Hand Surgery, Sahlgrenska University Hospital, Sweden; Department of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SwedenSydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, AustraliaInstitute for Public Health and Nursing Sciences, University of Bremen, GermanyCentro de Desportos, Universidade Federal de Santa Catarina, BrazilUMR 7194-HNHP, CNRS-MNHN, Département Homme et Environnement, Musée de l'Homme, Paris, France; Department of Human Origins, Max Planck Institute for Evolutionary Anthropology, GermanyDepartment of Physiotherapy, Kathmandu University School of Medical Sciences, NepalNational Institute of Public Health, University of Southern Denmark, DenmarkInternational Institute for Health and Society, Department of Epidemiology and Public Health, University College London, UKInstitute for Sport and Health, University College Dublin, IrelandInstitute of Sports and Sports Science, Karlsruhe Institute of Technology, GermanyPhysical Education Department, Federal University of Viçosa, BrazilDisability Prevention Program, St. Jude Children's Research Hospital, USAEnvironmental and Population Health Monitoring Centre, National Institute of Public Health, Czech RepublicClinical Nutrition Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, MexicoCenter for Geriatrics and Gerontology, Taipei Veterans General Hospital; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University; Taipei Municipal Gan-Dau HospitalFaculty of Education, University of Macau, Macao, ChinaDepartment of Medicine, Universiti Malaya Medical Centre, MalaysiaPostgraduate Program in Public Health (PPGSCol), University of the Extreme South of Santa Catarina (UNESC), BrazilMRC Lifecourse Epidemiology Centre, University of Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, UKFacultad de Ciencias del Deporte y la Educación Física, Universidad de Cundinamarca, ColombiaMission pour la Science Ouverte, Institut de Recherche pour le Développement, FrancePopulation Institute, University of the Philippines, PhilippinesInstitute of Human Movement Sciences and Sport (IBWS), Department of Health Sciences and Technology, ETH Zurich, Switzerland; OST—Eastern Swiss University of Applied Sciences, Department of Health, Switzerland; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, SwedenInstitute of Biomedicine, University of León, Spain; Division of Biological Sciences and Health, University of Sonora, MexicoCenter for Studies in Public Health and Aging—Federal University of Minas Gerais and Oswaldo Cruz Foundation-Minas Gerais, BrazilDepartamento de Nutrição Social, Faculdade de Nutrição Emilia de Jesus Ferreiro, Universidade Federal Fluminense (UFF), BrazilUniversidad Autónoma de Nuevo León, Facultad de Organización Deportiva Monterrey, MexicoDepartment of Internal Medicine, Ribeirao Preto Medical School, University of São Paulo, BrazilSchool of Psychology, University of Sussex, UKThe North-Western State Medical University named after I.I. Mechnikov, RussiaNutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Australia; School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, EthiopiaDepartment of Industrial Engineering, College of Engineering, Alfaisal University, Saudi ArabiaAdelaide Medical School, The University of Adelaide, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, AustraliaFacultad de Ciencias del Deporte y la Educación Física, Universidad de Cundinamarca, Colombia; Graduate School of Human Sciences, Osaka University, JapanPostgraduate Program in Nutrition and Food, Federal University of Pelotas, Brazil; Pennington Biomedical Research Center, USAEscuela Nacional de Antropologia e Historia, Instituto Nacional de Antropologia e Historia, MexicoMRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, UKMRC Lifecourse Epidemiology Centre, University of Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, UKNeuromuscular Investigation Center, Institute of Myology, FranceInstitute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), GermanyDepartment of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, JapanAlliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, AustraliaMax Planck Institute for Demographic Research, Germany; National Research University Higher School of Economics, RussiaDepartment of Medicine, University of Cambridge, UKInstitute of Radiology, University-Hospital Erlangen, Germany; Institute of Medical Physics, University of Erlangen-Nürnberg, GermanyThe Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College Dublin, IrelandMeasurement and Evaluation in Physical Education and Sport Science, Korea National Sport University, Republic of KoreaDepartment of Human Origins, Max Planck Institute for Evolutionary Anthropology, GermanyDepartment of Sport Science and Physical Education, The University of Agder, NorwayInstitute of Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Medical Faculty of the Martin-Luther-University Halle-Wittenberg, GermanyDepartment of Health and Welfare Science, School of Lifelong Sport, Hokusho University, Japan; Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, JapanSchool of Occupational Therapy, Faculty of Medicine, Hebrew University, IsraelDepartment of Public Health, Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, DenmarkCenter for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University; Department of Family Medicine, Taipei Veterans General Hospital Yuanshan BranchFaculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, UKDepartment of Sport, Exercise and Health, University of Basel, SwitzerlandSchool of Public Health and Information Sciences, University of Louisville, USAResearch Laboratory on Human Aging—GeronLab, Internal Medicine Department, Faculty of Medical Sciences, State University of Rio de Janeiro, Brazil; Department of Medicine, Pontifical Catholic University, BrazilCentre for Ageing Research and Education, Duke-National University of Singapore Medical School, Singapore; Health Services and Systems Research, Duke-National University of Singapore Medical School, SingaporeDepartment of Kinesiology and Health Education, University of Texas, USA; School of Public Health and Information Sciences, University of Louisville, USAGraduate School of Human Sciences, Osaka University, JapanSchool of Occupational Therapy, Faculty of Medicine, Hebrew University, IsraelSydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, AustraliaThe Irish Longitudinal Study on Ageing (TILDA), Trinity Central, Trinity College Dublin, IrelandCentre for Brain Research, Indian Institute of Science, IndiaHealth Foresight and Innovation Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, IranResearch Laboratory on Human Aging—GeronLab, Internal Medicine Department, Faculty of Medical Sciences, State University of Rio de Janeiro, BrazilTokyo Metropolitan Institute for Geriatrics and Gerontology (TMIG), JapanBerman Centre for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, USA; University of Minnesota, USADepartment of Educational Psychology, Faculty of Education, State University of Campinas, BrazilInstitute of Sports and Sports Science, Karlsruhe Institute of Technology, GermanyDivision of Biological Sciences and Health, University of Sonora, MexicoServicio de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, Spain; IBIMA/plataforma Bionand, Spain; Departamento de Medicina y Dermatología, Universidad de Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, SpainSchool of Public Health and Preventive Medicine, Monash University, AustraliaDepartment of Epidemiology and Population Studies, Jagellonian University Collegium Medicum, PolandDepartment of Kinesiology, College of Health & Human Services, Sacramento State University, USADeakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Australia; Department of Medicine—Western Health, The University of Melbourne, AustraliaEscuela Nacional de Antropologia e Historia, Instituto Nacional de Antropologia e Historia, MexicoPostgraduate program in Health Sciences at the Faculty of Medical Sciences of Minas Gerais, BrazilInstitute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Germany; Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Pettenkofer School of Public Health, GermanyDepartment of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, ChinaSergio Arouca National School of Public Health, Oswaldo Cruz Foundation, BrazilInstitute for Sport and Health, University College Dublin, Ireland; Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, UKNavarrabiomed, Hospital Universitario de Navarra (HUN)-Universidad Pública de Navarra (UPNA), IdiSNA, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, SpainLicenciatura en Nutriología, Facultad de Estudios Superiores Zaragoza, Universidad Nacional Autónoma de México, MexicoSchool of Public Health and Preventive Medicine, Monash University, AustraliaLocomotor Apparatus and Rehabilitation Institute, Faculty of Medicine, Universidad Austral de Chile, ChileServicio de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, Spain; IBIMA/plataforma Bionand, SpainWorkplace Health Promotion Research Center, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, IranDepartment of Sport, Exercise and Health, University of Basel, SwitzerlandTokyo Metropolitan Institute for Geriatrics and Gerontology, JapanDepartment of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, MalaysiaNutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Australia; Medical School, The University Western Australia, AustraliaDepartment of Physical Health and Ageing, Norwegian Institute of Public Health, NorwayResearch Division, Institute of Mental Health, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, SingaporeDepartment of Geriatric and Palliative Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark; Department of Clinical Medicine, Faculty of Health, University of Copenhagen, DenmarkDeakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), AustraliaCentre for Brain Research, Indian Institute of Science, IndiaGraduate School of Health and Sports Science, Juntendo University, JapanInstitute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, LithuaniaDivision of Geriatric Medicine, Department of Medicine, Universiti Malaya, MalaysiaTokyo Metropolitan Institute of Gerontology, JapanInstitute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Germany; Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Pettenkofer School of Public Health, GermanyThe North-Western State Medical University named after I.I. Mechnikov, RussiaCenter for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Health Service Research and Innovation Unit, Diakonhjemmet Hospital, Norway; Department of Rehabilitation Science and Health Technology, Institute of Health Sciences, Oslo Metropolitan University, NorwayDepartment of Sport, Exercise and Health, University of Basel, SwitzerlandPhysical Fitness Research and Health Guidance Center, Shanghai Research Institute of Sports Science (Shanghai Anti-Doping Agency), ChinaDepartment of Physical Therapy, School of Health and Human Sciences, Indiana University Indianapolis, USASchool for Interprofessional Health Care, Cooperative State University Baden-Wuerttemberg, GermanyHealth and Social Sciences Cluster, Singapore Institute of Technology, Singapore; Geriatric Education and Research Institute, SingaporeMRC Lifecourse Epidemiology Centre, University of Southampton, UKInstitute of Health Sciences, Medical College of Rzeszow University, PolandInstitute of Sports and Sports Science, Karlsruhe Institute of Technology, GermanyDepartment of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical and Research Center, The University of Tokyo, JapanDepartment of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; CUHK Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, ChinaBackground: Muscular strength is a powerful marker of current health status and robust predictor of age-related disease and disability. Handgrip strength (HGS) using isometric dynamometry is a convenient, feasible, and widely used method of assessing muscular strength among people of all ages. While adult HGS norms have been published for many countries, no study has yet synthesized available data to produce international norms. The objective of this study was to generate international sex- and age-specific norms for absolute and body size-normalized HGS across the adult lifespan. Methods: Systematic searches were conducted in 6 databases/web search engines (MEDLINE, SPORTDiscus, Embase, Web of Science, CINAHL, and Google Scholar) up to December 1, 2023. We included full-text peer-reviewed observational studies that reported normative HGS data for adults aged ≥20 years by sex and age. Pseudo data were generated using Monte Carlo simulation following harmonization for methodological variation. Population-weighted Generalized Additive Models for Location, Scale, and Shape were used to develop sex- and age-specific norms for absolute HGS (kg) and HGS normalized by height (Ht, m) squared (i.e., HGS/Ht2 in kg/m2). Norms were tabulated as percentile values (5th to 95th) and visualized as smoothed percentile curves. Results: We included data from 100 unique observational studies representing 2,405,863 adults (51.9% female) aged 20 to 100+ years from 69 countries and regions tested from the year 2000 onward. On average, absolute and normalized HGS values negligibly improved throughout early adulthood, peaked from age 30–39 years (at 49.7 kg (males) and 29.7 kg (females) for absolute HGS or 16.3 kg/m2 (males) and 11.3 kg/m2 (females) for HGS/Ht2), and declined afterwards. The age-related decline in HGS accelerated from middle to late adulthood and was slightly larger for males than for females during middle adulthood. Conclusion: This study provides the world's largest and most geographically comprehensive international norms for adult HGS by sex and age. These norms have utility for global peer-comparisons, health screening, and surveillance.http://www.sciencedirect.com/science/article/pii/S2095254624001741AdultReference valuesHand strengthMass screeningPopulation health |
| spellingShingle | Grant R. Tomkinson Justin J. Lang Lukáš Rubín Ryan McGrath Bethany Gower Terry Boyle Marilyn G. Klug Alexandra J. Mayhew Henry T. Blake Francisco B. Ortega Cristina Cadenas-Sanchez Costan G. Magnussen Brooklyn J. Fraser Tetsuhiro Kidokoro Yang Liu Kaare Christensen Darryl P. Leong Mette Aadahl Edimansyah Abdin Julian Alcazar Aqeel Alenazi Bader Alqahtani Cledir De A. Amaral Thatiana L.M. Amaral Alex Andrade Fernandes Peter Axelsson Jennifer N. Baldwin Karin Bammann Aline R. Barbosa Ameline Bardo Inosha Bimali Peter Bjerregaard Martin Bobak Colin A. Boreham Klaus Bös João Carlos Bouzas Marins Joshua Burns Nadezda Capkova Lilia Castillo-Martínez Liang-Kung Chen Siu Ming Choi Rebecca K.J. Choong Susana C. Confortin Cyrus Cooper Jorge E. Correa-Bautista Amandine Cournil Grace Cruz Eling D. de Bruin José Antonio De Paz Bruno De Souza Moreira Luiz Antonio Dos Anjos María Cristina Enríquez Reyna Eduardo Ferriolli Gillian Forrester Elena Frolova Abadi K. Gebre Atef M. Ghaleb Tiffany K. Gill Yasuyuki Gondo M. Cristina Gonzalez Citlali Gonzalez Alvarez Mary K. Hannah Nicholas C. Harvey Jean-Yves Hogrel Marie-Theres Huemer Toshiko Iidaka Lewis A. Ingram Dmitri A. Jdanov Victoria L. Keevil Wolfgang Kemmler Rose Anne Kenny Dae-Yeon Kim Tracy L. Kivell Ingirid G.H. Kjær Alexander Kluttig Rumi Kozakai Danit Langer Lisbeth A. Larsen Wei-Ju Lee David A. Leon Eric Lichtenstein Bertis B. Little Roberto Alves Lourenço Rahul Malhotra Robert M. Malina Kiyoaki Matsumoto Tal Mazor-Karsenty Marnee J. McKay Sinéad McLoughlin Abhishek L. Mensegere Mostafa Mohammadian Virgilio Garcia Moreira Hiroshi Murayama Anne Murray Anita Liberalesso Neri Claudia Niessner Gabriel Núñez Othón Gabriel Olveira Suzanne G. Orchard Andrezj Pajak Chan Woong Park Julie A. Pasco Maria E. Peña Reyes Leani Souza Máximo Pereira Annette Peters Eric Tsz-Chun Poon Margareth C. Portela Jedd Pratt Robinson Ramírez-Vélez Wendy Rodríguez-García Joanne Ryan Mauricio A. San-Martín Francisco José Sánchez-Torralvo Mahnaz Saremi Arno Schmidt-Trucksäss Satoshi Seino Shamsul Azhar Shah Marc Sim Bjørn Heine Strand Mythily Subramaniam Charlotte Suetta Sophia X. Sui Jonas S. Sundarakumar Koya Suzuki Abdonas Tamosiunas Maw Pin Tan Yu Taniguchi Barbara Thorand Anna Turusheva Anne Therese Tveter Jonathan Wagner Dao Wang Stuart J. Warden Julia Wearing Shiou Liang Wee Leo D. Westbury Agnieszka Wiśniowska-Szurlej Alexander Woll Noriko Yoshimura Ruby Yu International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions Journal of Sport and Health Science Adult Reference values Hand strength Mass screening Population health |
| title | International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions |
| title_full | International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions |
| title_fullStr | International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions |
| title_full_unstemmed | International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions |
| title_short | International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions |
| title_sort | international norms for adult handgrip strength a systematic review of data on 2 4 million adults aged 20 to 100 years from 69 countries and regions |
| topic | Adult Reference values Hand strength Mass screening Population health |
| url | http://www.sciencedirect.com/science/article/pii/S2095254624001741 |
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