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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 6  |  Issue : 3  |  Page : 155-157

Normative values of handgrip strength in children using a perineometer


Department of Neurosciences, DVVPF's College of Physiotherapy, Ahmednagar, Maharashtra, India

Date of Web Publication9-Aug-2017

Correspondence Address:
Vaishali Pornak
Ramchandra Vaity Chawl, Room No: 2, Namdeo Wadi, Panchpakhadi, Thane West, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhas.IJHAS_166_16

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  Abstract 


Context: The device used in this study is a perineometer. This study comprises 100 children (50 boys and 50 girls) in the age group of 6–12 years. Children with any musculoskeletal and neurological disorder were excluded from the study.
Aims: The aim of this study is to measure hand grip strength in children.
Settings And Design: The observational study was conducted in Dr. Vitthalrao Vikhe Patil's CBSE School, Ahmednagar.
Subjects And Methods: The children were asked to sit on a chair with an armrest. The cuff was inflated till 100 mmHg. The children were told to press the transducer of the perineometer up to their maximum strength and release it. This process was repeated for three times, and the maximum strength was noted for both the right and left hand. Armrest chair, perineometer were used.
Statistical Analysis Used: Unpaired t-test.
Results: The mean grip strength in boys is 72.6 mmHg on the right side and 67.18 mmHg on the left and 6.92 mmHg on the right and 58 mmHg on the left in girls.
Conclusions: This study has provided the normative values of grip strength which can be used as a reference measure for detecting the abnormality in handgrip strength.

Keywords: Grip strength, handheld dynamometer, perineometer


How to cite this article:
Pornak V, Ganvir S. Normative values of handgrip strength in children using a perineometer. Int J Health Allied Sci 2017;6:155-7

How to cite this URL:
Pornak V, Ganvir S. Normative values of handgrip strength in children using a perineometer. Int J Health Allied Sci [serial online] 2017 [cited 2017 Dec 15];6:155-7. Available from: http://www.ijhas.in/text.asp?2017/6/3/155/212591




  Introduction Top


The instrument to measure handgrip strength in children as well as in adults is a handheld dynamometer. Studies of grip strength (all from the United States) have used a range of dynamometers-pneumatic and hydraulic manometers, spring-loaded resistances, and cable tensiometers.[1],[2],[3],[4],[5] Majority of studies have sampled adults only and no one has included children under 10 years of age. Nearly, all the dynamometers in clinical use have comparatively narrow ranges and test basically isotonic contraction.

The criterion for measuring handgrip strength is to have the person press the handle of the dynamometer, which shows the amount of pressure exerted on the device. In general, dynamometers available are designed for adults but have a few methods for accommodating smaller hands (e.g., numerous hand-size adjustments). These procedures present challenges when used to examine children whose hands are smaller than those of an adult.[6],[7] These devices when used in children, they experience difficulty in holding the device which causes pain and imprecise readings. Hence, there is a need for an instrument which the children might find it easy and will be comfortable for them to handle. Occupational therapists modify dynamometer equipment to accommodate a child's undersized hand and other persons with hand problems. However, these modifications are made within individual occupational therapy clinics and are not readily available to other clinicians.[8]

The perineometer is a device used for assessing the strength of voluntary contractions of the pelvic floor muscles. It becomes difficult for the children to press the metal handle of the dynamometer. Therefore, we are using a perineometer for measuring the handgrip strength in children because it is easy for them to press the transducer of the perineometer.

To the best of our knowledge, there is no evidence on normative values of handgrip strength in children using a perineometer which thus became the purpose of our study.


  Subjects and Methods Top


One hundred children in the age group of 6–12 years were included in the study. The sampling technique was convenient sampling. Children with any musculoskeletal and neurological disorders were excluded from the study. Distribution of boys and girls in the different age group is shown in [Table 1].
Table 1: Distribution of children according to age and gender

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Equipment

A perineometer, shown in [Figure 1], is a device used to measure the voluntary strength of pelvic floor muscles in women. It consists of a dial which shows readings in mmHg, a transducer, an inflatable cuff, and a rubber tube which connects the dial to the transducer.
Figure 1: Device used in the study

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Procedure

Written assent was obtained from the child's parent. The participants were given a demonstration before the testing. Each participant was made to sit on an armrest chair facing the researcher. The children were told to press the transducer of the perineometer up to their maximum strength and release it. This process was repeated for 3 times for each hand with a pause of 10 s between two readings. The maximum strength was noted for both the right and left hand.


  Results Top


[Table 2] represents descriptive statistics (mean and standard deviations) in each age group. Unpaired t-test was used at P< 0.0001 level of significance. As age increases, the grip strength also advances starting from 54.25 mmHg at 6 years of age and advancing to 82.28 mmHg at 12 years of age. Majority of children were the right-handed dominant. Hence, the strength of the dominant hand was greater than the nondominant hand.
Table 2: Mean values of grip strength in boys and girls

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  Discussion Top


The Data composed in this study give information of the expected grip strength using a perineometer typically in children. Comparable to the results of the study conducted by Ager et al., 1984; Mathiowetz et al., 1986, our study also shows that as we grow old, the grip strength also goes on escalating.[6],[9] There is no conformity about whether girls and boys have the identical grip strength at every age.[9] In this study, girls recorded a smaller amount of grip strength as compared to boys at every age.

There is a large body of research examining the influence of hand dominance on handgrip, the majority of which suggests that the dominant hand is up to 10% stronger.[10] In this study, the right-hand side is the principal side in all ages and it shows more grip strength as compared to the left-hand side at all ages. It has been suggested that evaluating grip strength in the left-handed children; one should assume that both the hands are about equally strong, whereas right-handed children are expected to be up to 10% stronger with their right hand.[11]

Finally, the number of trials given may also influence handgriP values. Data in the present study are based on three trials; however, in a study conducted by Cohen et al.,[12] a subsample of children were given three attempts, with 88% of children achieving their best performance in the first two trials, a finding very similar to the 82.3% reported by Häger-Ross and Rösblad.[11] Therefore, we have used three trials because the use of two trials may result in a slight underestimation of mean Hg values compared with data based on three trials. Furthermore, it is acknowledged that three trials will provide more accurate maximum handgrip strength.

The perineometer is better handled by the children than the dynamometer. It can also be used in cerebral palsy children and in rheumatological conditions. Moreover, the perineometer is cheaper than the dynamometer. The perineometer shows parallel grip strength overall as compared to a standard dynamometer.


  Conclusion Top


This study has provided the normative values of grip strength which can be used as a reference measure for detecting the abnormality in handgrip strength.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Pierson WR, O'Connell EK. Age, height, weight and grip strength. Res Q 1961;33:439-43.  Back to cited text no. 1
    
2.
Schmidt RT, Toews JV. Grip strength as measured by the Jamar dynamometer. Arch Phys Med Rehabil 1970;51:321-7.  Back to cited text no. 2
    
3.
Swanson AB, Matev IB, de Groot G. The strength of the hand. Bull Prosthet Res 1970;10:145-53.  Back to cited text no. 3
    
4.
Beasley WC. Efficient estimators of normal adult grip strength. Arch Phys Med Rehabil 1973;54:573.  Back to cited text no. 4
    
5.
Montoye HJ, Lamphiear DE. Grip and arm strength in males and females, age 10 to 69. Res Q 1977;48:109-20.  Back to cited text no. 5
    
6.
Ager CL, Olivett BL, Johnson CL. Grasp and pinch strength in children 5 to 12 years old. Am J Occup Ther 1984;38:107-13.  Back to cited text no. 6
    
7.
Broadhead GD. Dynamometric grip strength in mildly handicapped children. Rehabil Lit 1975;36:279-83.  Back to cited text no. 7
    
8.
Robertson A, Deitz J. A description of grip strength in preschool children. Am J Occup Ther 1988;42:647-52.  Back to cited text no. 8
    
9.
Mathiowetz V, Wiemer DM, Federman SM. Grip and pinch strength: Norms for 6-to 19-year-olds. Am J Occup Ther 1986;40:705-11.  Back to cited text no. 9
    
10.
Inskip HM, Godfrey KM, Martin HJ, Simmonds SJ, Cooper C, Sayer AA; Southampton Women's Survey Study Group. Size at birth and its relation to muscle strength in young adult women. J Intern Med 2007;262:368-74.  Back to cited text no. 10
    
11.
Häger-Ross C, Rösblad B. Norms for grip strength in children aged 4-16 years. Acta Paediatr 2002;91:617-25.  Back to cited text no. 11
    
12.
Cohen DD, Voss C, Taylor MJ, Stasinopoulos DM, Delextrat A, Sandercock GR. Handgrip strength in English schoolchildren. Acta Paediatr 2010;99:1065-72.  Back to cited text no. 12
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2]



 

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  In this article
Abstract
Introduction
Subjects and Methods
Results
Discussion
Conclusion
References
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