title: Handgrip strength in cardiac rehabilitation: normative values, interaction with physical function, and response to training.
abstract: OBJECTIVE
  To determine normative values for handgrip (HG) strength at entry into cardiac rehabilitation (CR) and to examine the relationship of HG strength with self-reported physical function and the response of HG strength to exercise training.
  
  
  METHODS
  HG strength was measured in 1,960 patients with coronary heart disease. Other measures obtained included oxygen consumption/ unit time (peak VO2), body composition, physical function and depression questionnaires, and assessment of comorbid conditions. Subsequently, HG strength and other measures were obtained in 666 participants who completed 36 sessions of CR exercise training.
  
  
  RESULTS
  HG strength was significantly greater in men than in women (40.6 +/- 10.1 kg vs 22.6 +/- 6.5 kg, P < .0001), but diminished with age in both men and women from the third to the eight decade. Factors most strongly correlated with HG strength were gender (r = 0.40, P < .0001), height (r = 0.37, P < .0001), peak VO2 (r = 0.32, P < .0001), and age (r = -0.23, P < .0001). Baseline HG strength was correlated with physical function capacity in patients older than 65 years but not in younger patients. Following CR, HG strength increased overall by 4.6% in comparison with baseline values (34.9 +/- 11.4 to 36.5 +/- 11.6 kg, P < .0001). For the entire cohort, the increase in HG strength was associated with an increase in physical function score (P < .05).
  
  
  CONCLUSIONS
  In patients with coronary heart disease, HG strength decreases with age and is lower in women, patients with diabetes, and patients with lower peak Vo2. It remains to be determined whether a training protocol that specifically focuses on increasing HG strength would have a greater impact on overall functional status.
authors: Division of Cardiology, Department of Medicine, University of Vermont College of Medicine, Fletcher-Allen Health Care, Burlington, Vermont, USA.
authors: Alex
authors: A
authors: Mroszczyk-McDonald
authors: Patrick D
authors: PD
authors: Savage
authors: Philip A
authors: PA
authors: Ades
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000534:rehabilitation*; D003920:Diabetes Mellitus; D005080:Exercise Test; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000502:physiology*; D010101:Oxygen Consumption; D010865:Pilot Projects; D012016:Reference Values; D012737:Sex Factors