Normative Data of Hand Grip Strength in Healthy Adult Pakistani Population

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.

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.

Eligibility Criteria:
Inclusion Criteria:

* Healthy Subjects as measured on Subjective Global Assessment Form

Exclusion Criteria:

* History/o upper limb surgery, deformity or related health condition
* No previous history pf participation in gym activities for last 06 months