Handgrip Strength as an Indicator of Overall Health Functionality

Clinical Value of Handgrip Strength

Handgrip strength dynamometry has been proposed as a simple and easy diagnostic method for identifying muscle weakness and can detect disorders even before changes in body composition parameters are identified, allowing for earlier nutritional interventions that may influence patient prognosis 1, 2
In hospitalized patients with kidney failure, handgrip strength values below 10 kg at discharge and below 15 kg one month after discharge were associated with increased risk of death 1
In patients on hemodialysis, handgrip strength correlates with the number of comorbidities and malnutrition inflammation scores, providing valuable clinical information 1
Higher handgrip strength is associated with lower odds of adverse events across multiple intrinsic capacity domains and lower rates of hospitalization compared to individuals with weaker grip strength 3

In cirrhosis patients, frailty manifested as functional decline in grip strength, gait speed, and other physical performance measures is associated with increased risk for complications requiring hospitalization or death while awaiting liver transplantation 4, 5
Low phase angle or handgrip strength allows assessment of mortality risk in liver disease patients 4, 5

The European Society for Clinical Nutrition and Metabolism (ESPEN) recommends assessing muscle function by hand-grip strength in collaborative patients with kidney disease 1
Despite its clinical value, handgrip strength should not be used in isolation due to certain limitations: it requires patient cooperation, lacks standardized measurement protocols, needs well-calibrated dynamometers adjusted for hand size, and lacks universal reference values 1, 2

For accurate measurements, handgrip dynamometers must be well-calibrated and adjusted for hand size 1
There is currently no absolute consensus on standardized measurement protocols for handgrip strength assessment 1
Standard reference values for handgrip strength are still lacking across different populations 1

In patients with non-healing wounds or gangrene, grip strength provides complementary information about overall functional status that impacts healing capacity, as recommended by the American College of Cardiology 6

For patients with non-healing lower extremity wounds, grip strength assessment can complement standard perfusion measures to provide a more comprehensive prediction of wound healing potential, according to the American College of Cardiology 6
In patients with peripheral artery disease (PAD) and chronic limb-threatening ischemia (CLTI), grip strength assessment adds value to standard perfusion measures by providing information about overall functional status and nutritional adequacy, as suggested by the American College of Cardiology 7, 8

While grip strength is a valuable predictor, direct perfusion measures remain the primary predictors of wound healing potential in vascular compromise, as stated by the American College of Cardiology 6, 7

Higher handgrip strength is strongly and independently associated with reduced all-cause mortality, cardiovascular death, and cancer mortality in older adults, serving as a reliable biomarker for overall health status and longevity regardless of chronic disease burden, according to the American College of Physicians 9

Lower odds of adverse events across all intrinsic capacity domains (cognition, mental health, sensory function, metabolic rate, mobility) and reduced hospitalization rates, particularly in men, are associated with higher grip strength, as recommended by the American Geriatrics Society 9

Malnutrition in older adults with diabetes associates with decreased grip strength, activities of daily living, physical performance, cognition, and quality of life, highlighting the importance of nutritional assessment and intervention in this population, according to the American Diabetes Association 10, 11
Diabetes accelerates muscle strength loss, poor muscle quality, and sarcopenia development, creating a vicious cycle of functional decline that grip strength captures early, as noted by the European Association for the Study of Diabetes 10, 11, 12

Resistance training targeting major muscle groups at least twice weekly on non-consecutive days, combined with adequate protein intake (≥30g daily), represents the evidence-based approach to improving grip strength and associated health outcomes, as recommended by the Academy of Nutrition and Dietetics 13
High-protein oral nutritional supplementation (>20% energy from protein) demonstrates improved grip strength, reduced complications, and decreased hospital readmissions across multiple settings, though no overall mortality benefit was observed, according to the European Society for Clinical Nutrition and Metabolism 13