Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, Brazil.
Department of Medicine, Pontifical Catholic University, Puerto Rico, Brazil.
PLoS One. 2021 May 4;16(5):e0250925. doi: 10.1371/journal.pone.0250925. eCollection 2021.
Handgrip strength (HGS) is an indicator of muscle strength, suited for evaluating the aging process. Its use depends on the availability of reliable normative reference values (NRV). The main objective of this study is to provide NRV of HGS for Brazilians aged 65 to 90 years.
Participants were from the Frailty in Brazilian Older People research. 2,999 successful aging (SA) participants comprised the development sample. HGS was measured using a hydraulic dynamometer. Obtaining NRV involved regressing HGS on age per sex-height strata, fitting separate fractional polynomial (FP) models for the mean and coefficient of variation. Model fit was assessed via standardized residuals, probability/quantile plots, and comparing observed to normal expected percentages of participants falling within specified centile intervals. For validation, the latter procedure was applied to 2,369 unsuccessfully aging (UA) participants.
Across strata, the best-fitting models for the means were FP of power 1. FP models for the CV indicated age invariance, entailing steady heteroscedastic age decline in SD since coefficients for the means were negative and SD = CV×mean. All models adjusted well. Centiles distributions for the SA and UA populations showed anticipated patterns, respectively falling on and below the normative expected centile references. Results (NRV) are presented in tables and centile charts. Equations are also provided.
NRV/charts may be endorsed for routine use, while still tested further. They would aid professionals caring for older people, not only to identify those at risk and eligible for immediate provisions, but also in planning prevention and rehabilitation measures.
握力（HGS）是肌肉力量的指标，适用于评估衰老过程。其使用取决于是否有可靠的规范参考值（NRV）。本研究的主要目的是为 65 至 90 岁的巴西人提供 HGS 的 NRV。
参与者来自巴西老年人虚弱研究。2999 名成功衰老（SA）参与者构成了开发样本。使用液压测力计测量 HGS。获得 NRV 涉及按性别-身高分层回归 HGS 与年龄的关系，为均值和变异系数拟合单独的分数多项式（FP）模型。通过标准化残差、概率/分位数图以及比较观察到的与特定百分位区间内预期参与者百分比来评估模型拟合情况。为了验证，后一种方法应用于 2369 名未成功衰老（UA）参与者。
在各层中，均值的最佳拟合模型是幂 1 的 FP。CV 的 FP 模型表明年龄不变，这意味着 SD 随年龄呈稳定的异方差下降，因为均值的系数为负且 SD = CV×mean。所有模型都调整得很好。SA 和 UA 人群的百分位数分布分别呈现出预期的模式，分别落在和低于规范预期的百分位参考值上。结果（NRV）以表格和百分位图表的形式呈现。还提供了方程。
NRV/图表可以得到认可并常规使用，同时仍需要进一步测试。它们将有助于照顾老年人的专业人员，不仅可以识别有风险和有资格获得即时供应的人，还可以规划预防和康复措施。
