Acta Scientific Orthopaedics (ISSN: 2581-8635)

Volume 2 Issue 10 October 2019

Research Article

Correlation of Forearm Circumference and Hand Length with Grip Strength in

Healthy Young Adults

Seethamma KM1, Joseph Oliver Raj2*, Nithin Prakash3 and Kshama Shetty4
1
Post Graduate student, Alva’s college of Physiotherapy, Dakshin Karnataka, India
2
Principal, Alva’s college of Physiotherapy, Dakshin Karnataka, India
3
Lecturer, Alva’s college of Physiotherapy, Dakshin Karnataka, India
4
Associate Professor, Alva’s college of Physiotherapy, Dakshin Karnataka, India
*Corresponding Author: Joseph Oliver Raj, Alva’s College of Physiotherapy, Dakshin Karnataka, India.
Received: August 14, 2019; Published: September 12, 2019

Abstract
Introduction: Grip strength measurement is used as an indicator for many hand and forearm related orthopaedic injuries as well as
in neurological assessment.
Aim: To find whether anthropometric measurements like hand length and forearm circumference have influence on hand grip
strength of young healthy adults.
Material and Methods: 198 healthy young adults were used for the study for data collection. Grip strength of both hands were done
with hand held dynamometer. Anthropometric measurements of hand length and forearm circumference was done using measuring
tape.
Results and Discussion: The result showed that there is statistical significance between hand grip strength and both anthropometric
measurements, that is, hand length and forearm circumference.
Conclusions: Hand grip strength has direct correlation with the anthropometric measurement of hand length and forearm
circumference. Hence hand grip strength is associated with hand length and forearm circumference irrespective of age and gender.
Keywords: Grip Strength; Forearm Circumference; Dynamometer; Hand Length

Introduction in likelihood of falls and fractures in osteoporosis [2]. The dyna-

Human hand is noted for its complex structure and devoted mometer has been found to give the most accurate and acceptable
motor function of manipulation and sensory functions of relaying measures of grip strength by quantifying the amount of static force
various deep and superficial sensations to the brain [1]. The highly with which the hand can squeeze the dynamometer and is com-
elaborated nervous control, sensitivity of the fingers and the abil- monly measured in Kilograms or pounds [2].
ity to perform firm grip contributes to the sensory and motor effi-
cacies of hand complex. Clinically the overall physical strength and The information regarding human sizes is essential in designing
health are done by assessing the hand grip strength. The impor- various facilities and an anthropometric measurement of hand is
tance of hand strength has been identified in predicting disability very important for designing of various objects dealing with human
in musculoskeletal diseases and bone mineral density as well as hands. There has been a positive correlation between grip strength

Citation: Joseph Oliver Raj., et al. “Correlation of Forearm Circumference and Hand Length with Grip Strength in Healthy Young Adults". Acta Scientific
Orthopaedics 2.10 (2019): 10-15.
Correlation of Forearm Circumference and Hand Length with Grip Strength in Healthy Young Adults

11

and anthropometrics including hand anthropometric measure- Grip strength measurement

ments in healthy Indian men [1]. The force applied by the hand Can be measured by using hand dynamometer. Normal value for
to pull on or suspend from objects is called the grip strength, a adult male / female in kg [6]
specific part of hand strength [3]. Objects with an optimum size
of around 1 - 3 inches diameter permit the hand to wrap around Male Female
objects, which are usually cylindrical in nature. Excellent >64 >38
Very good 56-64 34-38
Grip strength is often used in physiotherapy as a specific type Above average 52-55 30-33
of hand strength, purpose of testing, including to diagnose disease, Average 48-51 26-29
evaluate and compare treatment, to document progression of mus-
Below average 44-47 23-25
cle strength and provide feedback during rehabilitation process as
Poor 40-43 20-22
a measure indicating the level of hand function, and also be able to
Very poor <40 <20
predict a decline in function in old age.
Table A:
Many factors which includes fatigue, hand dominance, time of
day, state of nutrition, pain, cooperation of patients, presence of Methodology and Materials
amputation, restriction of movements, sensory loss are affected by The subjects for this observational study design were selected
hand grip [4]. by simple random sampling.

Types of grips The study sample size is 198 subjects and study was done for a
Hand grips are divided into the following: duration of three months.

Power grip: There are 3 types: Inclusion riteria

a) Cylindrical: All fingers are flexed around the object • Apparently healthy individuals both males and females
which is usually at a right angle to the forearm and the of age between 18 to 24 years
thumb around the object held. • Willingness to participate
b) Spherical: All the fingers and the thumb are adducted
Exclusion criteria
around the object. Fingers spread apart, palm often not
involved. • History of any systemic disorders
• History of any fracture, hand or nerve injury in upper
c) Hook grip: Involve second through fifth finger flexed
around an object in a hook like manner. Usually thumb limb
is not involved. • Pain in the upper extremity

Precision grip • Post - surgical condition and neurological pathology.

• Tends to hold the object between the tips of the finger Materials
and thumb • Consent form
• Thumb is abducted • Recording sheets
• Used in the fine movements and accuracy • Hydraulic hand dynamometer
• Objects are small or fragile • Inch tape
• No involvement of palm and proximal joints • Weighing machine
There are 4 types • Stadiometer

1. Pad to pad (pinch) Procedure

2. Tip to tip (pincer grip) After clearance from institutions ethical clearance committee,
3. Lateral prehension a prior informed consent was obtained from the participants and
4. Lumbrical grip those who fulfilled the selection criteria were selected among those
individuals. Simple random sampling method was used for selec-
tion.

Citation: Joseph Oliver Raj., et al. “Correlation of Forearm Circumference and Hand Length with Grip Strength in Healthy Young Adults". Acta Scientific
Orthopaedics 2.10 (2019): 10-15.
Correlation of Forearm Circumference and Hand Length with Grip Strength in Healthy Young Adults

12

Handle should be squeezed tightly till needle stops.

Readings of measurements are taken in kg which is seen in out-

er dial and total of three readings are taken alternatively for both
hands.

Figure 1: Stadiometer.

Figure 3: Position of patient with hand held dynamometer.

Hand dimension measurements

The measurement techniques of hand dimensions were carried
out by using a standard measurement tape as proposed for both
hands [7]. Largest and thinnest parts of forearm were taken for
forearm and wrist circumference.

Perimeter of the middle part of the hand was considered for

Figure 2: Electronic Weighing scale. palm length. For palm length, distance from the distal wrist crease
up to the base of the middle finger and lastly for the hand length,
the distal wrist crease to the tip of the middle finger was consid-
Hand held dynamometer [5] ered for measurement.
Record the participant’s hand dominance. Participants were
made to be seated in a comfortable chair with back support and
fixed arm rest. Participants were informed to keep their forearm
on the arms of chair and feet flat on the ground.

When squeezing the dynamometer, participants feet should not

raise from the ground and the thumb should be facing upwards
with the hand placed at edge of the chair’s arm.

Handle should be grasped from one side with thumb and other
side with fingers.

Position of red needle on dial should be at “0” when starting the Figure 4: Hand dimensions measurement.
procedure.

Citation: Joseph Oliver Raj., et al. “Correlation of Forearm Circumference and Hand Length with Grip Strength in Healthy Young Adults". Acta Scientific
Orthopaedics 2.10 (2019): 10-15.
Correlation of Forearm Circumference and Hand Length with Grip Strength in Healthy Young Adults

13

Forearm circumference measurements Std. Std. Error

Mean N
With arm extended, measurement of forearm girth was taken Deviation Mean
where maximum muscle bulk was present in forearm with 3 read- Pair 1 Hand length 19.03 188 1.825 0.133
ings [7]. (Cm) R
Grip strength 25.21 188 9.975 0.727
right

Table 3: Paired Samples Statistics.

N Correlation Sig.
Pair 1 Hand length (Cm) R and 188 0.366 0.000
grip strength right

Table 4: Paired Samples Correlations.

ANOVA
Sum of Mean
BMI Df F Sig.
Figure 5: Forearm circumference measurement. Squares Square
Between Groups 614.613 38 16.174 1.175 0.246
Within Groups 2050.595 149 13.762
Statistical analysis
Total 2665.207 187
Statistical analysis was done using SPSS 20 and T test was used
for statistical measurement for grip strength and forearm circum- Table 5: Grip strength left- BMI.
ference and hand length. Statistical method used between grip
strength and BMI was ANOVA. ANOVA
T-Test Sum of Mean
BMI Df F Sig.
Squares Square
Std. Std. Error Between Groups 846.142 39 21.696 1.765 0.008
Mean N
Deviation Mean Within Groups 1819.065 148 12.291
Forearm Total 2665.207 187
Circumference 25.49 43 4.026 0.614
Pair 1 Left Table 6: Grip strength right- BMI.
Grip Strength
24.21 43 10.188 1.554
Left

Table 1: Paired Samples Statistics.

N Correlation Sig.
Pair 1 Forearm circumference left 43 0.035 0.826
and Grip strength left

Table 2: Paired Samples Correlations.

Figure 6: Graph representing distribution of male and female

participants.

Citation: Joseph Oliver Raj., et al. “Correlation of Forearm Circumference and Hand Length with Grip Strength in Healthy Young Adults". Acta Scientific
Orthopaedics 2.10 (2019): 10-15.
Correlation of Forearm Circumference and Hand Length with Grip Strength in Healthy Young Adults

14

The grip strength depends on the synergistic forearm flexor and

extensor muscle action and its interplay [8]. Movement of the fore-
arm and hand are mostly performed by forearm muscles.

The flexor muscles of the forearm and hand create grip strength
while performing gripping activities whereas the stabilization of
the wrist is carried by the extensors of the forearm [9].
Figure 7: Graphical representation of forearm circumference and
grip strength. There was statistical analysis between all anthropometric data
and grip strength in both males and females that showed a posi-
tive correlation. This finding was similar to the report from study
which showed strong correlation between hand circumference and
grip strength [10]. Therefore, muscle strength is impaired in obese
people due to the sedentary lifestyle and low physical fitness [11].
Also, there was significant correlation with forearm circumference
and hand grip strength, the higher the forearm diameter the higher
is the grip strength [12].

The fibber diameter of the flexor digitorum sublimes on the

Figure 8: Graphical representation of hand length and grip flexion contractile ability of the hand influences and explains the
strength. correlation between forearm girth and handgrip strength. Conse-
quently, the forearm circumference and hand length can be used as
a medium of hand grip strength among young adults [12-27].
Results and Discussion
Conclusion
From the results of this study, it is evident that the correlation
between forearm circumference and hand grip strength (both right Hand grip strength has direct correlation with the anthropo-
and left) is statistically significant which is similar to the studies by metric measurement of hand length and forearm circumference.
other prominent authors in the past. There is statistically signifi- Hence hand grip strength is associated with hand length and fore-
cant correlation between hand length and hand grip strength on arm circumference irrespective of age and gender.
both right and left sides. Conflict of Interest
No conflict of interest in any matter existed among the corre-
Physical strength of an individual is measured by assessing the sponding author and other authors.
effective muscle contraction. Muscle contraction depends on cross
Bibliography
sectional area of muscle and its intensity of recruitment. Individu-
als with more type II fibres have greater physical endurance. The 1. Shah UN., et al. “The association between hand grip strength
strength capability analysis is done by asking the individual to per- and hand dimensions in healthy Indian females”. International
Journal of Current Research and Review 4.2 (2012).
form a particular task like pushing or lifting an object.
2. Angst F., et al. “Prediction of grip and key pinch strength in 978
The observations are compared with capabilities of a section of healthy subjects”. BMC Musculoskeletal Disorders 11 (2010):
population. The quantification of hand grip strength can be done 94.
by measurement of static force that the hand exerts on a dyna-
3. Babu YK and Saraswathi P. “A study on influence of wrist joint
mometer [1]. position grip strength in normal adult male individuals”. Inter-
nal Journal of Drug Development and Research (2014).

Citation: Joseph Oliver Raj., et al. “Correlation of Forearm Circumference and Hand Length with Grip Strength in Healthy Young Adults". Acta Scientific
Orthopaedics 2.10 (2019): 10-15.
Correlation of Forearm Circumference and Hand Length with Grip Strength in Healthy Young Adults

15

4. Adedoyin RA., et al. “References values for hand grip strength 17. Chilima DM and Ismail SJ. “Nutrition and hand grip strength
among healthy adults in Nigeria”. Hong Kong Physiotherapy of older adults in rural Malawi”. Public Health Nutrition 4.1
Journal 27.1 (2009): 21-29. (2001):11-17.

5. Mathiowetz V. “Comparison of Rolyan and Jamar dynamom- 18. Pieterse S., et al. “The association between nutritional status
eters for measuring grip strength”. Occupational Therapy In- and hand grip strength in older Rwandan refugees”. Europe-
ternationa 9.3 (2002): 201-209. an Journal of Clinical Nutrition 56.10 (2002): 933-939.

6. Massey-Westrop N., et al. “Measuring grip strength in normal 19. Abbott JH CE., et al. “The initial effects of an elbow mobiliza-
adult: reference ranges and a comparison of electronic and tion with movement technique on grip strength in subjects
hydraulic instruments”. Journal of Hand Surgery American with lateral epicondylalgia”. Manual Therapy 6.3 (2001):
29.3 (2004): 514-519. 163-169.

7. Mohan V., et al. “Forearm circumference and hand length pre- 20. Mostert, R., et al. “Tissue depletion and health related qual-
dicts maximal hand grip strength among Malaysian popula- ity of life in patients with chronic obstructive pulmonary dis-
tion”. Middle East Journal of Scientific Research 21.4 (2014): ease”. Respiratory Medicine 94.9 (2000): 859-867.
634-639.
21. Stalenhoef PA., et al. “A risk model for the prediction of re-
8. Ahmed T. “The effect of upper extremity ftigue on grip current falls in community dwelling elderly: a prospective
strength and passing accuracy in junior basketball players”. cohort study”. Journal of Clinical Epidemiology 55.11 (2002):
Journal of Human kinetics 37 (2013): 71-79. 1088-1094.

9. Butefisch C., et al. “Repetitive training of isolated movements 22. Ali NA., et al. “Midwest Critical Care Consortium Acquired
improves the outcome of motor rehabilitation of the cen- weakness, handgrip strength and mortality in critically ill
trally paretic hand”. Journal of the Neurological Sciences 130.1 patients”. American Journal of Respiratory and Critical Care
(1995): 59-68. Medicine 178.3 (2008): 261-268.

10. Li K., et al. “Predicting maximal grip strength using hand cir- 23. Norman K., et al. “Hand grip strength: outcome predictor and
cumference”. Manual Therapy 15.6 (2010): 579-585. marker of nutritional status”. Clinical Nutrition 30.2 (2011):
135-142.
11. Rolland Y., et al. “Muscle strength in obese elderly women: ef-
fect of recreational physical activity in cross-sectional study”. 24. Wind AE., et al. “Is grip strength a predictor for total muscle
American Journal of Clinical Nutrition 79.4 (2004): 552-557. strength in healthy children, adolescents and young adults?”.
European Journal of Pediatrics 169.3 (2010):281-287.
12. Okaraogur U., et al. “Association of grip strength with anthro-
pometric measures: Height, forearm diameter and middle 25. Sultan P., et al. “Preoperative muscle weakness as defined by
finger length in young adults”. Polish Annals of Medicine 24.2 handgrip strength and postoperative outcomes: a systematic
(2017): 153-157. review”. BMC Anesthesiol 169 (2012): 281-287.

13. Ling CH., et al. “Handgrip strength and mortality in the oldest 26. Kamarul T., et al. “Hand grip strength in the adult Malaysian
old population: the Leiden 85-plus study”. Canadian Medical population”. Journal of Orthopaedic Surgery (Hong Kong) 14.2
Association Journal 182.5 (2010):429-435. (2006): 172-177.

14. Foo LH., et al. “Influence of body composition, muscle 27. SmidtN., et al. “Interobserver Reproducibility of the Assess-
strength, diet and physical activity on total body and forearm ment of Severity of Complaints, Grip Strength, and Pres-
bone mass in Chinese adolescent girls”. British Journal of Nu- sure Pain Threshold in Patients with Lateral Epicondyli-
trition 98.6 (2007):1281-1287. tis”. Archives of Physical Medicine and Rehabilitation 83.8
(2002):1145-1150.
15. Samson MM., et al. “Relationships between physical perfor-
mance measures, age, height and body weight in healthy
adults”. Age and Ageing 29.3 (2000): 235-242.
Volume 2 Issue 10 October 2019
© All rights are reserved by Joseph Oliver Raj., et al.
16. Onder G., et al. “Change in physical performance over time in
older women: the women’s Health and Aging Study”. The jour-
nals of gerontology. Series A, Biological sciences and medical
sciences 57.5 (2002): M289-M293.

Citation: Joseph Oliver Raj., et al. “Correlation of Forearm Circumference and Hand Length with Grip Strength in Healthy Young Adults". Acta Scientific
Orthopaedics 2.10 (2019): 10-15.