Growth diagrams for grip strength in children

H M Ties Molenaar, Ruud W Selles, J Michiel Zuidam, Sten P Willemsen, Henk J Stam, Steven E R Hovius, H M Ties Molenaar, Ruud W Selles, J Michiel Zuidam, Sten P Willemsen, Henk J Stam, Steven E R Hovius

Abstract

Grip strength dynamometers often are used to assess hand function in children. The use of normative grip strength data at followup is difficult because of the influence of growth and neuromuscular maturation. As an alternative, infant welfare centers throughout the world use growth diagrams to observe normative growth. The aim of this study was to develop similar growth diagrams for grip strength in children. We measured the grip strength, hand dominance, gender, height, and weight of 225 children, 4 to 12 years old. We developed separate statistical models for both hands of boys and girls for drawing growth curves. Grip strength increased with age for both hands. For the whole group, the dominant hand produced higher grip strength than the nondominant hand and boys were stronger than girls. The grip strength of boys and girls differed between 2 and 19 N for the different age groups. Because grip strength measurements are accompanied by a rather large variance, the growth diagrams (presenting a continuum in grip strength) make it possible to better observe grip strength development with time corresponding to a more exact age. Depending on the accuracy needed, the use of one combined diagram could be considered.

Level of evidence: Level II, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.

Figures

Fig. 1
Fig. 1
A 6-year-old child holds a Jamar-like dynamometer (Lode dynamometer). The electronic console was facing the researcher so that no feedback was provided to the subjects.
Fig. 2
Fig. 2
A graph shows grip strength for the dominant hand in boys plotted against age. The centiles 2.5%, 16%, 50%, 84%, and 97.5% are shown.
Fig. 3
Fig. 3
A graph shows grip strength for the nondominant hand in boys plotted against age. The centiles 2.5%, 16%, 50%, 84%, and 97.5% are shown.
Fig. 4
Fig. 4
A graph shows grip strength for the dominant hand in girls plotted against age. The centiles 2.5%, 16%, 50%, 84%, and 97.5% are shown.
Fig. 5
Fig. 5
A graph shows grip strength for the nondominant hand in girls plotted against age. The centiles 2.5%, 16%, 50%, 84%, and 97.5% are shown.
Fig. 6
Fig. 6
A graph shows grip strength for the mean hand strength (dominant and nondominant combined) for all subjects (boys and girls combined) plotted against age. The centiles 2.5%, 16%, 50%, 84%, and 97.5% are shown.

References

    1. Altman DG. Construction of age-related reference centiles using absolute residuals. Stat Med. 1993;12:917–924. doi: 10.1002/sim.4780121003.
    1. American Society of Hand Therapists. Clinical Assessment Recommendations. Ed 2. Chigago, IL; 1992.
    1. Bellace JV, Healy D, Besser MP, Byron T, Hohman L. Validity of the Dexter Evaluation System’s Jamar dynamometer attachment for assessment of hand grip strength in a normal population. J Hand Ther. 2000;13:46–51.
    1. Bohannon RW, Schaubert KL. Test-retest reliability of grip-strength measures obtained over a 12-week interval from community-dwelling elders. J Hand Ther. 2005;18:426–427. doi: 10.1197/j.jht.2005.07.003.
    1. Clerke AM, Clerke JP, Adams RD. Effects of hand shape on maximal isometric grip strength and its reliability in teenagers. J Hand Ther. 2005;18:19–29. doi: 10.1197/j.jht.2004.10.007.
    1. Cole TJ. Using the LMS method to measure skewness in the NCHS and Dutch National height standards. Ann Hum Biol. 1989;16:407–419. doi: 10.1080/03014468900000532.
    1. Cole TJ. The LMS method for constructing normalized growth standards. Eur J Clin Nutr. 1990;44:45–60.
    1. De Smet L, Vercammen A. Grip strength in children. J Pediatr Orthop B. 2001;10:352–354. doi: 10.1097/00009957-200110000-00017.
    1. Firrell JC, Crain GM. Which setting of the dynamometer provides maximal grip strength? J Hand Surg Am. 1996;21:397–401. doi: 10.1016/S0363-5023(96)80351-0.
    1. Fredriks AM, van Buuren S, Jeurissen SE, Dekker FW, Verloove-Vanhorick SP, Wit JM. Height, weight, body mass index and pubertal development reference values for children of Turkish origin in the Netherlands. Eur J Pediatr. 2003;162:788–793. doi: 10.1007/s00431-003-1292-x.
    1. Fredriks AM, van Buuren S, Jeurissen SE, Dekker FW, Verloove-Vanhorick SP, Wit JM. Height, weight, body mass index and pubertal development references for children of Moroccan origin in The Netherlands. Acta Paediatr. 2004;93:817–824.
    1. Gupta A, Kay S, Scheker R. The Growing Hand: Diagnosis and Management of the Upper Extremity in Children. London, England: Mosby; 2000.
    1. Mathiowetz V. Comparison of Rolyan and Jamar dynamometers for measuring grip strength. Occup Ther Int. 2002;9:201–209. doi: 10.1002/oti.165.
    1. Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S. Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil. 1985;66:69–74.
    1. Mathiowetz V, Weber K, Volland G, Kashman N. Reliability and validity of grip and pinch strength evaluations. J Hand Surg Am. 1984;9:222–226.
    1. Mathiowetz V, Wiemer DM, Federman SM. Grip and pinch strength: norms for 6- to 19-year-olds. Am J Occup Ther. 1986;40:705–711.
    1. Molenaar HM, Zuidam JM, Selles RW, Stam HJ, Hovius SE. Age-specific reliability of two grip-strength dynamometers when used by children. J Bone Joint Surg Am. 2008;90:1053–1059. doi: 10.2106/JBJS.G.00469.
    1. Schreuders TA, Roebroeck ME, Goumans J, van Nieuwenhuijzen JF, Stijnen TH, Stam HJ. Measurement error in grip and pinch force measurements in patients with hand injuries. Phys Ther. 2003;83:806–815.
    1. Smidt N, van der Windt DA, Assendelft WJ, Mourits AJ, Deville WL, de Winter AF, Bouter LM. Interobserver reproducibility of the assessment of severity of complaints, grip strength, and pressure pain threshold in patients with lateral epicondylitis. Arch Phys Med Rehabil. 2002;83:1145–1150. doi: 10.1053/apmr.2002.33728.
    1. van den Beld WA, van der Sanden GA, Sengers RC, Verbeek AL, Gabreels FJ. Validity and reproducibility of the Jamar dynamometer in children aged 4–11 years. Disabil Rehabil. 2006;28:1303–1309. doi: 10.1080/09638280600631047.

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