International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions

Grant R. Tomkinson; Justin J. Lang; Lukáš Rubín; Ryan McGrath; Bethany Gower; Terry Boyle; Marilyn G. Klug; Alexandra J. Mayhew; Henry T. Blake; Francisco B. Ortega; Cristina Cadenas-Sanchez; Costan G. Magnussen; Brooklyn J. Fraser; Tetsuhiro Kidokoro; Yang Liu; Kaare Christensen; Darryl P. Leong; Mette Aadahl; Edimansyah Abdin; Julian Alcazar; Aqeel Alenazi; Bader Alqahtani; Cledir De A. Amaral; Thatiana L.M. Amaral; Alex Andrade Fernandes; Peter Axelsson; Jennifer N. Baldwin; Karin Bammann; Aline R. Barbosa; Ameline Bardo; Inosha Bimali; Peter Bjerregaard; Martin Bobak; Colin A. Boreham; Klaus Bös; João Carlos Bouzas Marins; Joshua Burns; Nadezda Capkova; Lilia Castillo-Martínez; Liang Kung Chen; Siu Ming Choi; Rebecca K.J. Choong; Susana C. Confortin; Cyrus Cooper; Jorge E. Correa-Bautista; Amandine Cournil; Grace Cruz; Eling D. de Bruin; José Antonio De Paz; Bruno De Souza Moreira; Luiz Antonio Dos Anjos; María Cristina Enríquez Reyna; Eduardo Ferriolli; Gillian Forrester; Elena Frolova; Abadi K. Gebre; Atef M. Ghaleb; Tiffany K. Gill; Yasuyuki Gondo; M. Cristina Gonzalez; Citlali Gonzalez Alvarez; Mary K. Hannah; Nicholas C. Harvey; Jean Yves Hogrel; Marie Theres Huemer; Toshiko Iidaka; Lewis A. Ingram; Dmitri A. Jdanov; Victoria L. Keevil; Wolfgang Kemmler; Rose Anne Kenny; Dae Yeon Kim; Tracy L. Kivell; Ingirid G.H. Kjær; Alexander Kluttig; Rumi Kozakai; Danit Langer; Lisbeth A. Larsen; Wei Ju Lee; David A. Leon; Eric Lichtenstein; Bertis B. Little; Roberto Alves Lourenço; Rahul Malhotra; Robert M. Malina; Kiyoaki Matsumoto; Tal Mazor-Karsenty; Marnee J. McKay; Sinéad McLoughlin; Abhishek L. Mensegere; Mostafa Mohammadian; Virgilio Garcia Moreira; Hiroshi Murayama; Anne Murray; Anita Liberalesso Neri; Claudia Niessner; Gabriel Núñez Othón; Gabriel Olveira; Suzanne G. Orchard; Andrezj Pajak; Chan Woong Park; Julie A. Pasco; Maria E.Peña Reyes; Leani Souza Máximo Pereira; Annette Peters; Eric Tsz Chun Poon; Margareth C. Portela; Jedd Pratt; Robinson Ramírez-Vélez; Wendy Rodríguez-García; Joanne Ryan; Mauricio A. San-Martín; Francisco José Sánchez-Torralvo; Mahnaz Saremi; Arno Schmidt-Trucksäss; Satoshi Seino; Shamsul Azhar Shah; Marc Sim; Bjørn Heine Strand; Mythily Subramaniam; Charlotte Suetta; Sophia X. Sui; Jonas S. Sundarakumar; Koya Suzuki; Abdonas Tamosiunas; Maw Pin Tan; Yu Taniguchi; Barbara Thorand; Anna Turusheva; Anne Therese Tveter; Jonathan Wagner; Dao Wang; Stuart J. Warden; Julia Wearing; Shiou Liang Wee; Leo D. Westbury; Agnieszka Wiśniowska-Szurlej; Alexander Woll; Noriko Yoshimura; Ruby Yu

doi:10.1016/j.jshs.2024.101014

International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions

Grant R. Tomkinson^*, Justin J. Lang, Lukáš Rubín, Ryan McGrath, Bethany Gower, Terry Boyle, Marilyn G. Klug, Alexandra J. Mayhew, Henry T. Blake, Francisco B. Ortega, Cristina Cadenas-Sanchez, Costan G. Magnussen, Brooklyn J. Fraser, Tetsuhiro Kidokoro, Yang Liu, Kaare Christensen, Darryl P. Leong, Mette Aadahl, Edimansyah Abdin, Julian AlcazarAqeel Alenazi, Bader Alqahtani, Cledir De A. Amaral, Thatiana L.M. Amaral, Alex Andrade Fernandes, Peter Axelsson, Jennifer N. Baldwin, Karin Bammann, Aline R. Barbosa, Ameline Bardo, Inosha Bimali, Peter Bjerregaard, Martin Bobak, Colin A. Boreham, Klaus Bös, João Carlos Bouzas Marins, Joshua Burns, Nadezda Capkova, Lilia Castillo-Martínez, Liang Kung Chen, Siu Ming Choi, Rebecca K.J. Choong, Susana C. Confortin, Cyrus Cooper, Jorge E. Correa-Bautista, Amandine Cournil, Grace Cruz, Eling D. de Bruin, José Antonio De Paz, Bruno De Souza Moreira, Luiz Antonio Dos Anjos, María Cristina Enríquez Reyna, Eduardo Ferriolli, Gillian Forrester, Elena Frolova, Abadi K. Gebre, Atef M. Ghaleb, Tiffany K. Gill, Yasuyuki Gondo, M. Cristina Gonzalez, Citlali Gonzalez Alvarez, Mary K. Hannah, Nicholas C. Harvey, Jean Yves Hogrel, Marie Theres Huemer, Toshiko Iidaka, Lewis A. Ingram, Dmitri A. Jdanov, Victoria L. Keevil, Wolfgang Kemmler, Rose Anne Kenny, Dae Yeon Kim, Tracy L. Kivell, Ingirid G.H. Kjær, Alexander Kluttig, Rumi Kozakai, Danit Langer, Lisbeth A. Larsen, Wei Ju Lee, David A. Leon, Eric Lichtenstein, Bertis B. Little, Roberto Alves Lourenço, Rahul Malhotra, Robert M. Malina, Kiyoaki Matsumoto, Tal Mazor-Karsenty, Marnee J. McKay, Sinéad McLoughlin, Abhishek L. Mensegere, Mostafa Mohammadian, Virgilio Garcia Moreira, Hiroshi Murayama, Anne Murray, Anita Liberalesso Neri, Claudia Niessner, Gabriel Núñez Othón, Gabriel Olveira, Suzanne G. Orchard, Andrezj Pajak, Chan Woong Park, Julie A. Pasco, Maria E.Peña Reyes, Leani Souza Máximo Pereira, Annette Peters, Eric Tsz Chun Poon, Margareth C. Portela, Jedd Pratt, Robinson Ramírez-Vélez, Wendy Rodríguez-García, Joanne Ryan, Mauricio A. San-Martín, Francisco José Sánchez-Torralvo, Mahnaz Saremi, Arno Schmidt-Trucksäss, Satoshi Seino, Shamsul Azhar Shah, Marc Sim, Bjørn Heine Strand, Mythily Subramaniam, Charlotte Suetta, Sophia X. Sui, Jonas S. Sundarakumar, Koya Suzuki, Abdonas Tamosiunas, Maw Pin Tan, Yu Taniguchi, Barbara Thorand, Anna Turusheva, Anne Therese Tveter, Jonathan Wagner, Dao Wang, Stuart J. Warden, Julia Wearing, Shiou Liang Wee, Leo D. Westbury, Agnieszka Wiśniowska-Szurlej, Alexander Woll, Noriko Yoshimura, Ruby Yu

^*Corresponding author for this work

School of Occupational Therapy

Research output: Contribution to journal › Review article › peer-review

1 Scopus citations

Abstract

Background: Muscular strength is a powerful marker of current health status and robust predictor of age-related disease and disability. Handgrip strength (HGS) using isometric dynamometry is a convenient, feasible, and widely used method of assessing muscular strength among people of all ages. While adult HGS norms have been published for many countries, no study has yet synthesized available data to produce international norms. The objective of this study was to generate international sex- and age-specific norms for absolute and body size-normalized HGS across the adult lifespan. Methods: Systematic searches were conducted in 6 databases/web search engines (MEDLINE, SPORTDiscus, Embase, Web of Science, CINAHL, and Google Scholar) up to December 1, 2023. We included full-text peer-reviewed observational studies that reported normative HGS data for adults aged ≥20 years by sex and age. Pseudo data were generated using Monte Carlo simulation following harmonization for methodological variation. Population-weighted Generalized Additive Models for Location, Scale, and Shape were used to develop sex- and age-specific norms for absolute HGS (kg) and HGS normalized by height (Ht, m) squared (i.e., HGS/Ht² in kg/m²). Norms were tabulated as percentile values (5th to 95th) and visualized as smoothed percentile curves. Results: We included data from 100 unique observational studies representing 2,405,863 adults (51.9% female) aged 20 to 100+ years from 69 countries and regions tested from the year 2000 onward. On average, absolute and normalized HGS values negligibly improved throughout early adulthood, peaked from age 30–39 years (at 49.7 kg (males) and 29.7 kg (females) for absolute HGS or 16.3 kg/m² (males) and 11.3 kg/m² (females) for HGS/Ht²), and declined afterwards. The age-related decline in HGS accelerated from middle to late adulthood and was slightly larger for males than for females during middle adulthood. Conclusion: This study provides the world's largest and most geographically comprehensive international norms for adult HGS by sex and age. These norms have utility for global peer-comparisons, health screening, and surveillance.

Original language	English
Article number	101014
Journal	Journal of Sport and Health Science
Volume	14
DOIs	https://doi.org/10.1016/j.jshs.2024.101014
State	Published - Dec 2025

Bibliographical note

Publisher Copyright:
© 2025

Keywords

Adult
Hand strength
Mass screening
Population health
Reference values

Access to Document

10.1016/j.jshs.2024.101014

Cite this

Tomkinson, G. R., Lang, J. J., Rubín, L., McGrath, R., Gower, B., Boyle, T., Klug, M. G., Mayhew, A. J., Blake, H. T., Ortega, F. B., Cadenas-Sanchez, C., Magnussen, C. G., Fraser, B. J., Kidokoro, T., Liu, Y., Christensen, K., Leong, D. P., Aadahl, M., Abdin, E., ... Yu, R. (2025). International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions. Journal of Sport and Health Science, 14, Article 101014. https://doi.org/10.1016/j.jshs.2024.101014

@article{48fd4797cf424715b5af7dc5b24f984c,

title = "International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions",

abstract = "Background: Muscular strength is a powerful marker of current health status and robust predictor of age-related disease and disability. Handgrip strength (HGS) using isometric dynamometry is a convenient, feasible, and widely used method of assessing muscular strength among people of all ages. While adult HGS norms have been published for many countries, no study has yet synthesized available data to produce international norms. The objective of this study was to generate international sex- and age-specific norms for absolute and body size-normalized HGS across the adult lifespan. Methods: Systematic searches were conducted in 6 databases/web search engines (MEDLINE, SPORTDiscus, Embase, Web of Science, CINAHL, and Google Scholar) up to December 1, 2023. We included full-text peer-reviewed observational studies that reported normative HGS data for adults aged ≥20 years by sex and age. Pseudo data were generated using Monte Carlo simulation following harmonization for methodological variation. Population-weighted Generalized Additive Models for Location, Scale, and Shape were used to develop sex- and age-specific norms for absolute HGS (kg) and HGS normalized by height (Ht, m) squared (i.e., HGS/Ht2 in kg/m2). Norms were tabulated as percentile values (5th to 95th) and visualized as smoothed percentile curves. Results: We included data from 100 unique observational studies representing 2,405,863 adults (51.9% female) aged 20 to 100+ years from 69 countries and regions tested from the year 2000 onward. On average, absolute and normalized HGS values negligibly improved throughout early adulthood, peaked from age 30–39 years (at 49.7 kg (males) and 29.7 kg (females) for absolute HGS or 16.3 kg/m2 (males) and 11.3 kg/m2 (females) for HGS/Ht2), and declined afterwards. The age-related decline in HGS accelerated from middle to late adulthood and was slightly larger for males than for females during middle adulthood. Conclusion: This study provides the world's largest and most geographically comprehensive international norms for adult HGS by sex and age. These norms have utility for global peer-comparisons, health screening, and surveillance.",

keywords = "Adult, Hand strength, Mass screening, Population health, Reference values",

author = "Tomkinson, {Grant R.} and Lang, {Justin J.} and Luk{\'a}{\v s} Rub{\'i}n and Ryan McGrath and Bethany Gower and Terry Boyle and Klug, {Marilyn G.} and Mayhew, {Alexandra J.} and Blake, {Henry T.} and Ortega, {Francisco B.} and Cristina Cadenas-Sanchez and Magnussen, {Costan G.} and Fraser, {Brooklyn J.} and Tetsuhiro Kidokoro and Yang Liu and Kaare Christensen and Leong, {Darryl P.} and Mette Aadahl and Edimansyah Abdin and Julian Alcazar and Aqeel Alenazi and Bader Alqahtani and Amaral, {Cledir De A.} and Amaral, {Thatiana L.M.} and Fernandes, {Alex Andrade} and Peter Axelsson and Baldwin, {Jennifer N.} and Karin Bammann and Barbosa, {Aline R.} and Ameline Bardo and Inosha Bimali and Peter Bjerregaard and Martin Bobak and Boreham, {Colin A.} and Klaus B{\"o}s and Marins, {Jo{\~a}o Carlos Bouzas} and Joshua Burns and Nadezda Capkova and Lilia Castillo-Mart{\'i}nez and Chen, {Liang Kung} and Choi, {Siu Ming} and Choong, {Rebecca K.J.} and Confortin, {Susana C.} and Cyrus Cooper and Correa-Bautista, {Jorge E.} and Amandine Cournil and Grace Cruz and {de Bruin}, {Eling D.} and {De Paz}, {Jos{\'e} Antonio} and Moreira, {Bruno De Souza} and Anjos, {Luiz Antonio Dos} and Reyna, {Mar{\'i}a Cristina Enr{\'i}quez} and Eduardo Ferriolli and Gillian Forrester and Elena Frolova and Gebre, {Abadi K.} and Ghaleb, {Atef M.} and Gill, {Tiffany K.} and Yasuyuki Gondo and Gonzalez, {M. Cristina} and Alvarez, {Citlali Gonzalez} and Hannah, {Mary K.} and Harvey, {Nicholas C.} and Hogrel, {Jean Yves} and Huemer, {Marie Theres} and Toshiko Iidaka and Ingram, {Lewis A.} and Jdanov, {Dmitri A.} and Keevil, {Victoria L.} and Wolfgang Kemmler and Kenny, {Rose Anne} and Kim, {Dae Yeon} and Kivell, {Tracy L.} and Kj{\ae}r, {Ingirid G.H.} and Alexander Kluttig and Rumi Kozakai and Danit Langer and Larsen, {Lisbeth A.} and Lee, {Wei Ju} and Leon, {David A.} and Eric Lichtenstein and Little, {Bertis B.} and Louren{\c c}o, {Roberto Alves} and Rahul Malhotra and Malina, {Robert M.} and Kiyoaki Matsumoto and Tal Mazor-Karsenty and McKay, {Marnee J.} and Sin{\'e}ad McLoughlin and Mensegere, {Abhishek L.} and Mostafa Mohammadian and Moreira, {Virgilio Garcia} and Hiroshi Murayama and Anne Murray and Neri, {Anita Liberalesso} and Claudia Niessner and Oth{\'o}n, {Gabriel N{\'u}{\~n}ez} and Gabriel Olveira and Orchard, {Suzanne G.} and Andrezj Pajak and Park, {Chan Woong} and Pasco, {Julie A.} and Reyes, {Maria E.Pe{\~n}a} and Pereira, {Leani Souza M{\'a}ximo} and Annette Peters and Poon, {Eric Tsz Chun} and Portela, {Margareth C.} and Jedd Pratt and Robinson Ram{\'i}rez-V{\'e}lez and Wendy Rodr{\'i}guez-Garc{\'i}a and Joanne Ryan and San-Mart{\'i}n, {Mauricio A.} and S{\'a}nchez-Torralvo, {Francisco Jos{\'e}} and Mahnaz Saremi and Arno Schmidt-Trucks{\"a}ss and Satoshi Seino and Shah, {Shamsul Azhar} and Marc Sim and Strand, {Bj{\o}rn Heine} and Mythily Subramaniam and Charlotte Suetta and Sui, {Sophia X.} and Sundarakumar, {Jonas S.} and Koya Suzuki and Abdonas Tamosiunas and Tan, {Maw Pin} and Yu Taniguchi and Barbara Thorand and Anna Turusheva and Tveter, {Anne Therese} and Jonathan Wagner and Dao Wang and Warden, {Stuart J.} and Julia Wearing and Wee, {Shiou Liang} and Westbury, {Leo D.} and Agnieszka Wi{\'s}niowska-Szurlej and Alexander Woll and Noriko Yoshimura and Ruby Yu",

note = "Publisher Copyright: {\textcopyright} 2025",

year = "2025",

month = dec,

doi = "10.1016/j.jshs.2024.101014",

language = "אנגלית",

volume = "14",

journal = "Journal of Sport and Health Science",

issn = "2095-2546",

publisher = "Elsevier B.V.",

}

Tomkinson, GR, Lang, JJ, Rubín, L, McGrath, R, Gower, B, Boyle, T, Klug, MG, Mayhew, AJ, Blake, HT, Ortega, FB, Cadenas-Sanchez, C, Magnussen, CG, Fraser, BJ, Kidokoro, T, Liu, Y, Christensen, K, Leong, DP, Aadahl, M, Abdin, E, Alcazar, J, Alenazi, A, Alqahtani, B, Amaral, CDA, Amaral, TLM, Fernandes, AA, Axelsson, P, Baldwin, JN, Bammann, K, Barbosa, AR, Bardo, A, Bimali, I, Bjerregaard, P, Bobak, M, Boreham, CA, Bös, K, Marins, JCB, Burns, J, Capkova, N, Castillo-Martínez, L, Chen, LK, Choi, SM, Choong, RKJ, Confortin, SC, Cooper, C, Correa-Bautista, JE, Cournil, A, Cruz, G, de Bruin, ED, De Paz, JA, Moreira, BDS, Anjos, LAD, Reyna, MCE, Ferriolli, E, Forrester, G, Frolova, E, Gebre, AK, Ghaleb, AM, Gill, TK, Gondo, Y, Gonzalez, MC, Alvarez, CG, Hannah, MK, Harvey, NC, Hogrel, JY, Huemer, MT, Iidaka, T, Ingram, LA, Jdanov, DA, Keevil, VL, Kemmler, W, Kenny, RA, Kim, DY, Kivell, TL, Kjær, IGH, Kluttig, A, Kozakai, R, Langer, D, Larsen, LA, Lee, WJ, Leon, DA, Lichtenstein, E, Little, BB, Lourenço, RA, Malhotra, R, Malina, RM, Matsumoto, K, Mazor-Karsenty, T, McKay, MJ, McLoughlin, S, Mensegere, AL, Mohammadian, M, Moreira, VG, Murayama, H, Murray, A, Neri, AL, Niessner, C, Othón, GN, Olveira, G, Orchard, SG, Pajak, A, Park, CW, Pasco, JA, Reyes, MEP, Pereira, LSM, Peters, A, Poon, ETC, Portela, MC, Pratt, J, Ramírez-Vélez, R, Rodríguez-García, W, Ryan, J, San-Martín, MA, Sánchez-Torralvo, FJ, Saremi, M, Schmidt-Trucksäss, A, Seino, S, Shah, SA, Sim, M, Strand, BH, Subramaniam, M, Suetta, C, Sui, SX, Sundarakumar, JS, Suzuki, K, Tamosiunas, A, Tan, MP, Taniguchi, Y, Thorand, B, Turusheva, A, Tveter, AT, Wagner, J, Wang, D, Warden, SJ, Wearing, J, Wee, SL, Westbury, LD, Wiśniowska-Szurlej, A, Woll, A, Yoshimura, N & Yu, R 2025, 'International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions', Journal of Sport and Health Science, vol. 14, 101014. https://doi.org/10.1016/j.jshs.2024.101014

TY - JOUR

T1 - International norms for adult handgrip strength

T2 - A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions

AU - Tomkinson, Grant R.

AU - Lang, Justin J.

AU - Rubín, Lukáš

AU - McGrath, Ryan

AU - Gower, Bethany

AU - Boyle, Terry

AU - Klug, Marilyn G.

AU - Mayhew, Alexandra J.

AU - Blake, Henry T.

AU - Ortega, Francisco B.

AU - Cadenas-Sanchez, Cristina

AU - Magnussen, Costan G.

AU - Fraser, Brooklyn J.

AU - Kidokoro, Tetsuhiro

AU - Liu, Yang

AU - Christensen, Kaare

AU - Leong, Darryl P.

AU - Aadahl, Mette

AU - Abdin, Edimansyah

AU - Alcazar, Julian

AU - Alenazi, Aqeel

AU - Alqahtani, Bader

AU - Amaral, Cledir De A.

AU - Amaral, Thatiana L.M.

AU - Fernandes, Alex Andrade

AU - Axelsson, Peter

AU - Baldwin, Jennifer N.

AU - Bammann, Karin

AU - Barbosa, Aline R.

AU - Bardo, Ameline

AU - Bimali, Inosha

AU - Bjerregaard, Peter

AU - Bobak, Martin

AU - Boreham, Colin A.

AU - Bös, Klaus

AU - Marins, João Carlos Bouzas

AU - Burns, Joshua

AU - Capkova, Nadezda

AU - Castillo-Martínez, Lilia

AU - Chen, Liang Kung

AU - Choi, Siu Ming

AU - Choong, Rebecca K.J.

AU - Confortin, Susana C.

AU - Cooper, Cyrus

AU - Correa-Bautista, Jorge E.

AU - Cournil, Amandine

AU - Cruz, Grace

AU - de Bruin, Eling D.

AU - De Paz, José Antonio

AU - Moreira, Bruno De Souza

AU - Anjos, Luiz Antonio Dos

AU - Reyna, María Cristina Enríquez

AU - Ferriolli, Eduardo

AU - Forrester, Gillian

AU - Frolova, Elena

AU - Gebre, Abadi K.

AU - Ghaleb, Atef M.

AU - Gill, Tiffany K.

AU - Gondo, Yasuyuki

AU - Gonzalez, M. Cristina

AU - Alvarez, Citlali Gonzalez

AU - Hannah, Mary K.

AU - Harvey, Nicholas C.

AU - Hogrel, Jean Yves

AU - Huemer, Marie Theres

AU - Iidaka, Toshiko

AU - Ingram, Lewis A.

AU - Jdanov, Dmitri A.

AU - Keevil, Victoria L.

AU - Kemmler, Wolfgang

AU - Kenny, Rose Anne

AU - Kim, Dae Yeon

AU - Kivell, Tracy L.

AU - Kjær, Ingirid G.H.

AU - Kluttig, Alexander

AU - Kozakai, Rumi

AU - Langer, Danit

AU - Larsen, Lisbeth A.

AU - Lee, Wei Ju

AU - Leon, David A.

AU - Lichtenstein, Eric

AU - Little, Bertis B.

AU - Lourenço, Roberto Alves

AU - Malhotra, Rahul

AU - Malina, Robert M.

AU - Matsumoto, Kiyoaki

AU - Mazor-Karsenty, Tal

AU - McKay, Marnee J.

AU - McLoughlin, Sinéad

AU - Mensegere, Abhishek L.

AU - Mohammadian, Mostafa

AU - Moreira, Virgilio Garcia

AU - Murayama, Hiroshi

AU - Murray, Anne

AU - Neri, Anita Liberalesso

AU - Niessner, Claudia

AU - Othón, Gabriel Núñez

AU - Olveira, Gabriel

AU - Orchard, Suzanne G.

AU - Pajak, Andrezj

AU - Park, Chan Woong

AU - Pasco, Julie A.

AU - Reyes, Maria E.Peña

AU - Pereira, Leani Souza Máximo

AU - Peters, Annette

AU - Poon, Eric Tsz Chun

AU - Portela, Margareth C.

AU - Pratt, Jedd

AU - Ramírez-Vélez, Robinson

AU - Rodríguez-García, Wendy

AU - Ryan, Joanne

AU - San-Martín, Mauricio A.

AU - Sánchez-Torralvo, Francisco José

AU - Saremi, Mahnaz

AU - Schmidt-Trucksäss, Arno

AU - Seino, Satoshi

AU - Shah, Shamsul Azhar

AU - Sim, Marc

AU - Strand, Bjørn Heine

AU - Subramaniam, Mythily

AU - Suetta, Charlotte

AU - Sui, Sophia X.

AU - Sundarakumar, Jonas S.

AU - Suzuki, Koya

AU - Tamosiunas, Abdonas

AU - Tan, Maw Pin

AU - Taniguchi, Yu

AU - Thorand, Barbara

AU - Turusheva, Anna

AU - Tveter, Anne Therese

AU - Wagner, Jonathan

AU - Wang, Dao

AU - Warden, Stuart J.

AU - Wearing, Julia

AU - Wee, Shiou Liang

AU - Westbury, Leo D.

AU - Wiśniowska-Szurlej, Agnieszka

AU - Woll, Alexander

AU - Yoshimura, Noriko

AU - Yu, Ruby

PY - 2025/12

Y1 - 2025/12

N2 - Background: Muscular strength is a powerful marker of current health status and robust predictor of age-related disease and disability. Handgrip strength (HGS) using isometric dynamometry is a convenient, feasible, and widely used method of assessing muscular strength among people of all ages. While adult HGS norms have been published for many countries, no study has yet synthesized available data to produce international norms. The objective of this study was to generate international sex- and age-specific norms for absolute and body size-normalized HGS across the adult lifespan. Methods: Systematic searches were conducted in 6 databases/web search engines (MEDLINE, SPORTDiscus, Embase, Web of Science, CINAHL, and Google Scholar) up to December 1, 2023. We included full-text peer-reviewed observational studies that reported normative HGS data for adults aged ≥20 years by sex and age. Pseudo data were generated using Monte Carlo simulation following harmonization for methodological variation. Population-weighted Generalized Additive Models for Location, Scale, and Shape were used to develop sex- and age-specific norms for absolute HGS (kg) and HGS normalized by height (Ht, m) squared (i.e., HGS/Ht2 in kg/m2). Norms were tabulated as percentile values (5th to 95th) and visualized as smoothed percentile curves. Results: We included data from 100 unique observational studies representing 2,405,863 adults (51.9% female) aged 20 to 100+ years from 69 countries and regions tested from the year 2000 onward. On average, absolute and normalized HGS values negligibly improved throughout early adulthood, peaked from age 30–39 years (at 49.7 kg (males) and 29.7 kg (females) for absolute HGS or 16.3 kg/m2 (males) and 11.3 kg/m2 (females) for HGS/Ht2), and declined afterwards. The age-related decline in HGS accelerated from middle to late adulthood and was slightly larger for males than for females during middle adulthood. Conclusion: This study provides the world's largest and most geographically comprehensive international norms for adult HGS by sex and age. These norms have utility for global peer-comparisons, health screening, and surveillance.

AB - Background: Muscular strength is a powerful marker of current health status and robust predictor of age-related disease and disability. Handgrip strength (HGS) using isometric dynamometry is a convenient, feasible, and widely used method of assessing muscular strength among people of all ages. While adult HGS norms have been published for many countries, no study has yet synthesized available data to produce international norms. The objective of this study was to generate international sex- and age-specific norms for absolute and body size-normalized HGS across the adult lifespan. Methods: Systematic searches were conducted in 6 databases/web search engines (MEDLINE, SPORTDiscus, Embase, Web of Science, CINAHL, and Google Scholar) up to December 1, 2023. We included full-text peer-reviewed observational studies that reported normative HGS data for adults aged ≥20 years by sex and age. Pseudo data were generated using Monte Carlo simulation following harmonization for methodological variation. Population-weighted Generalized Additive Models for Location, Scale, and Shape were used to develop sex- and age-specific norms for absolute HGS (kg) and HGS normalized by height (Ht, m) squared (i.e., HGS/Ht2 in kg/m2). Norms were tabulated as percentile values (5th to 95th) and visualized as smoothed percentile curves. Results: We included data from 100 unique observational studies representing 2,405,863 adults (51.9% female) aged 20 to 100+ years from 69 countries and regions tested from the year 2000 onward. On average, absolute and normalized HGS values negligibly improved throughout early adulthood, peaked from age 30–39 years (at 49.7 kg (males) and 29.7 kg (females) for absolute HGS or 16.3 kg/m2 (males) and 11.3 kg/m2 (females) for HGS/Ht2), and declined afterwards. The age-related decline in HGS accelerated from middle to late adulthood and was slightly larger for males than for females during middle adulthood. Conclusion: This study provides the world's largest and most geographically comprehensive international norms for adult HGS by sex and age. These norms have utility for global peer-comparisons, health screening, and surveillance.

KW - Adult

KW - Hand strength

KW - Mass screening

KW - Population health

KW - Reference values

UR - http://www.scopus.com/inward/record.url?scp=85212417849&partnerID=8YFLogxK

U2 - 10.1016/j.jshs.2024.101014

DO - 10.1016/j.jshs.2024.101014

M3 - ???researchoutput.researchoutputtypes.contributiontojournal.systematicreview???

C2 - 39647778

AN - SCOPUS:85212417849

SN - 2095-2546

VL - 14

JO - Journal of Sport and Health Science

JF - Journal of Sport and Health Science

M1 - 101014

ER -

International norms for adult handgrip strength: A systematic review of data on 2.4 million adults aged 20 to 100+ years from 69 countries and regions

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