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握力不能被视为整体肌肉力量的替代指标。

Handgrip Strength Cannot Be Assumed a Proxy for Overall Muscle Strength.

机构信息

Department of Human Movement Sciences, AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands; Department of Medicine and Aged Care, AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia.

Department of Medicine and Aged Care, AgeMelbourne, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia.

出版信息

J Am Med Dir Assoc. 2018 Aug;19(8):703-709. doi: 10.1016/j.jamda.2018.04.019. Epub 2018 Jun 20.

DOI:10.1016/j.jamda.2018.04.019

PMID:29935982

Abstract

OBJECTIVES

Dynapenia, low muscle strength, is predictive for negative health outcomes and is usually expressed as handgrip strength (HGS). Whether HGS can be a proxy for overall muscle strength and whether this depends on age and health status is controversial. This study assessed the agreement between HGS and knee extension strength (KES) in populations differing in age and health status.

DESIGN

Data were retrieved from 5 cohorts.

SETTING AND PARTICIPANTS

Community, geriatric outpatient clinics, and a hospital. Five cohorts (960 individuals, 49.8% male) encompassing healthy young and older individuals, geriatric outpatients, and older individuals post hip fracture were included.

MEASURES

HGS and KES were measured according to the protocol of each cohort. Pearson correlation was performed to analyze the association between HGS and KES, stratified by sex. HGS and KES were standardized into sex-specific z scores. The agreement between standardized HGS and standardized KES at population level and individual level were assessed by intraclass correlation coefficients (ICC) and Bland-Altman analysis.

RESULTS

Pearson correlation coefficients were low in healthy young (male: 0.36 to 0.45, female: 0.45) and healthy older individuals (male: 0.35 to 0.37, female: 0.44), and moderate in geriatric outpatients (male and female: 0.54) and older individuals post hip fracture (male: 0.44, female: 0.57) (P < .05, except for male older individuals post hip fracture [P = .07]). Intraclass correlation coefficient values were poor to moderate in all populations (ie, healthy young individuals [0.41, 0.45], healthy older individuals [0.37, 0.41, 0.44], geriatric outpatients [0.54], and older individuals post hip fracture [0.54]). Bland-Altman analysis showed that within the same population of age and health status, agreement between HGS and KES varied on individual level.

CONCLUSIONS

At both population and individual level, HGS and KES showed a low to moderate agreement independently of age and health status. HGS alone should not be assumed a proxy for overall muscle strength.

摘要

目的

动力不足，即低肌肉力量，可以预测负面健康结果，通常用握力（HGS）来表示。HGS 是否可以作为整体肌肉力量的代表，以及这是否取决于年龄和健康状况，这是有争议的。本研究评估了在年龄和健康状况不同的人群中，HGS 与膝关节伸展力量（KES）之间的一致性。

设计

从 5 个队列中检索数据。

设置和参与者

社区、老年门诊诊所和医院。纳入了 5 个队列（960 人，49.8%为男性），包括健康的年轻人和老年人、老年门诊患者和髋部骨折后的老年人。

测量

根据每个队列的方案测量 HGS 和 KES。按性别分层，进行 Pearson 相关分析以分析 HGS 和 KES 之间的相关性。将 HGS 和 KES 标准化为性别特异性 z 分数。通过组内相关系数（ICC）和 Bland-Altman 分析评估人群水平和个体水平标准化 HGS 和标准化 KES 之间的一致性。

结果

在健康的年轻人（男性：0.36 至 0.45，女性：0.45）和健康的老年人（男性：0.35 至 0.37，女性：0.44）中，Pearson 相关系数较低，在老年门诊患者（男性和女性：0.54）和髋部骨折后的老年人（男性：0.44，女性：0.57）中，中等相关（P<.05，除了髋部骨折后的男性老年人 [P=0.07]）。在所有人群中，ICC 值均较差至中等（即健康的年轻人[0.41，0.45]，健康的老年人[0.37，0.41，0.44]，老年门诊患者[0.54]，髋部骨折后的老年人[0.54]）。Bland-Altman 分析表明，在相同的年龄和健康状况人群中，HGS 和 KES 之间的一致性在个体水平上有所不同。