The aim of this study was to determine the validity of reference equations of Lopes et al., Wang et al. and Amaral et al. for HGS in middle-aged women. Also, to investigate the determinants of HGS in middle-aged Indian women.
Four hundred and four Indian women aged 40-60 years were recruited for this cross-sectional study by purposive sampling and were classified as premenopausal and postmenopausal. Women were excluded if there were in perimenopause, obese, pregnancy in two years and use of hormone replacement, therapy. After initial screening, socioeconomic status, level of physical activity, anthropometric characteristics, menopause rating scale score, osteoporosis risk assessment scores, reproductive life span, parity and pulmonary function were recorded. Then, HGS was recorded for dominant and nondominant hand as per the ASTH protocol using a Jamar Hand Dynamometer.
The mean HGSDom among middle-aged women was 21.53±5.78.00 Kg. Independent t-test showed that the HGSDom and HGSNonDom values were significantly low in postmenopausal group as compared to the premenopausal group. Early menopausal women and surgical menopausal women also reported significant low values of HGS in comparison to premenopausal and postmenopausal women (p0.05). The Bland-Altman analysis was performed between the measured and predicted HGS. All three equations did not correctly predict HGS in Indian women (p0.05). Pearson correlation coefficients showed that age, height, upper limb length, forearm circumference, pulmonary function (FEV1, FVC, FEV1/FVC, MVV) were significantly correlated with HGS among middle-aged women. The forward multiple linear regression analyses identified the independent predictors of HGSDom and HGSNonDom respectively: HGSDom (kg)= -13.2335+10.889 x menopausal status (premenopausal =0, postmenopausal =1) +0.445 x upper limb length Dom (cm) (R2= 78.3%); HGSNonDom (kg) = -48.134+7.56 x menopausal status (premenopausal =0, postmenopausal =1) + 0.462 x upper limb length (cm) NonDom + 20.413 x height (m) (R2= 74.7%).
The HGS has been overestimated by the reference equations of Lopes et al, Wang et al and Amaral et al indicating that population specific equations are needed for accurate prediction of HGS. Menopause is an important factor influencing HGS and should be considered when assessing and prescribing rehabilitation in women. Newly developed equation will be useful for more precise clinical assessments and to customize rehabilitation programs of premenopausal as well as postmenopausal middle-aged Indian women
The findings from this study underscore the significant impact of menopausal status on HGS among middle-aged Indian women. The notable reductions in HGS of postmenopausal women compared to their premenopausal counterparts, it is essential for clinicians to consider menopausal status when assessing musculoskeletal health. The study highlights a critical need for population-specific reference standards. Integration of these findings into clinical practice can lead to more effective monitoring and management strategies for middle-aged women, particularly those transitioning through menopause, eventually promoting better health outcomes.
Hand Grip Strength
Physical Function
