Normative Data of Hand Grip Strength in Healthy Adult Pakistani Population
Condition: Health, Subjective
Study type: Observational

Summary: 
      Normative data values of handgrip strength not only describes hand normality but is also used
      as an objective assessor of upper extremities damages for Occupational Therapy and Physical
      Therapy interventions. Published normative data of different populations are widely available
      and can be used as reference. It is evident from different researches that various
      anthropometric variables such as age, gender, ethnicity, nutritional status, shoulder
      circumference & Body Mass Index(BMI), type of occupation and hand dominance of any population
      influence the hand muscles grip strength. Whereas, some literature shows disparity over the
      correlation between hand grip strength and BMI, several researchers claiming a positive
      relationship between BMI and grip strength in all ages of both genders, while other indicates
      no relationship.

      Approximately 3000 volunteers will be recruited from the staff, medical students, and
      visitors of different medical college & universities of Lahore. Subjects will be excluded if
      they had a history of upper-limb injury or deformity, or related health conditions.
      Socioeconomic background, general health, and lifestyle of the subjects will be assessed
      using a standard questionnaire. Weight, height & APM thickness will be measured prior to
      testing. Correlation between Hand Grip Strength and age, weight, height, body mass index
      (BMI), and Adductor Polices Muscle Thickness (APMT) will be measured. Multiple linear
      regression analysis will be used to adjust for the effects of other variables and to identify
      those independently associated with Hand grip strength. All the analysis will be carried out
      on SPSS v 25.
    

Detailed description: 
      In the last 20 years, a number of scientific publications from around the world point to
      hospital malnutrition as a direct cause for higher morbidity (slower wound healing; higher
      hospital infection rates; longer stay, especially among intensive care patients; higher
      readmission rates) and mortality. The obvious impact of such a scenario include avoidable
      deaths, additional costs for the social security system, and the social onus related to loss
      of working days.

      A wide variety of methods are available for nutritional evaluation. Not with standing, none
      of these can currently be considered as a ''gold-standard'' for diagnosing hospital
      malnutrition. Available methods include anthropometry, the creatinine height index, albumin,
      pre-albumin, immuno competence evaluation, cholesterol, and the prognostic nutritional index,
      among others. However, none of these methods provides a functional evaluation of
      malnutrition. SGA is a well-accepted method of nutritional assessment that addresses
      functional status as a complement of its medical history, but it was not developed to be used
      to evaluate responsiveness, and so, its rating are not expected to show any modification
      after nutritional interventions in short periods of time.

      There is evidence that muscular function is altered and muscular strength diminished, in the
      presence of malnutrition. According to Jeejeebhoy, malnutrition-related muscular function
      alterations appear before changes in anthropometric and laboratory parameters. Nevertheless,
      methods for evaluating muscular strength during nutritional evaluation are still scarce. The
      earliest nutritional alterations occur within muscle cells, and have an effect on muscle cell
      function. Measuring muscular strength may therefore provide a sensitive method for
      nutritional evaluation. Muscular loss is inevitable during malnutrition, and if untreated,
      may become progressive. Therefore, in addition to their ability to detect early alterations
      related to malnutrition, muscular function tests could also prove useful for evaluating
      nutritional recovery, underscoring the importance of such evaluation in this context.

      Recent studies have demonstrated the validity of using hand dynamometers as a method for
      nutritional evaluation, given that this is a simple, fast, useful, inexpensive, and
      efficacious test for muscular function. Knowledge of reference values in a healthy population
      would allow a functional muscle evaluation not only in hospital and research settings, but
      also in population-based studies. The aim of the study is to determine reference values and
      associated factors for hand grip strength in healthy individuals.
    

Observational model: Ecologic or Community
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Volunteers will be recruited from the staff, medical students, and visitors of different
        medical college & universities of Lahore. Subjects will be excluded if they had a history
        of upper-limb injury or deformity, or related health conditions. Socioeconomic background,
        general health, and lifestyle of the subjects will be assessed using a standard
        questionnaire. Weight, height & APM thickness will be measured prior to testing.
      
Keywords: Hand Grip Strength; Normative Data; Healthy Adults