Hand grip strength variability during serial testing as an entropic biomarker of aging: a Poincaré plot analysis

The Poincaré plot method can be used for both qualitative and quantitative assessment of self-similarity in usually periodic functions, hence the idea of applying it to the study of homeostasis of living organisms. From the analysis of numerous scientific data, it can be concluded that hand functionality can be correlated with the state of the human body as a biological system exposed to various forms of ontogenetic stress.

We used the Poincaré plot method to analyze the variability of hand grip strength (HGS), as an entropic biomarker of aging, during 60 repetitive tests of the dominant and nondominant hand, in young and older healthy subjects. An observational cross-sectional study was performed on 80 young adults (18-22 years old, mean age 20.01 years) and 80 older people (65-69 years old, mean age 67.13 years), with a sex ratio of 1:1 for both groups. For statistical analysis, we applied univariate descriptive statistics and inferential statistics (Shapiro-Wilk test, Mann-Whitney U-test for independent large samples, with the determination of the effect size coefficient r, and simple linear regression. We calculated the effect of fatigue and the Poincaré indices SD₁, SD₂, SD₁/SD₂ and the area of the fitting ellipse (AFE) for the test values of each subject.

The analysis of the differences between groups revealed statistically significant results for most HGS-derived indices (p ≤ 0.05), and the magnitude of the differences indicated, in most situations, a large effect size (r > 0.5). Our results demonstrate that the proposed repetitive HGS testing indicates relevant differences between young and older healthy subjects. Through the mathematical modeling of data and the application of the concept of entropy, we provide arguments supporting this new design of HGS testing.

Our results indicate that the variability of HGS during serial testing, which reflects complex repetitive biomechanical functions, represents an efficient indicator for differentiation between young and older hand function patterns from an entropic perspective. In practical terms, the variability of HGS, evaluated by the new serial testing design, can be considered an attractive and relatively simple biomarker to use for gerontological studies.