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Updated: Oct 13, 2026
Manual Muscle Testing: A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients
Published on: April 12, 2011
Handgrip and Pinch Grip Strength as Functional Indicators of Pediatric Malnutrition and Early Response to Nutritional
Mehmet Emin Yıldız1, Tuğba Gürsoy Koca2, Halil Kocamaz3
1Department of Pediatrics, Ministry of Health Serinhisar District State Hospital, Denizli 20430, Turkey.
Insights
Handgrip strength is a valuable functional marker for assessing pediatric malnutrition, reflecting nutritional status even after accounting for growth. Recovery varies, highlighting the need for careful interpretation alongside normal development.
Area of Science:
- Pediatric Nutrition
- Clinical Assessment
- Muscle Physiology
Background:
- Pediatric malnutrition leads to muscle mass loss and functional impairment.
- Current diagnostic tools primarily rely on anthropometrics, with limited functional indicators for early detection.
- Handgrip strength shows promise as an objective marker, but pediatric data is scarce.
Purpose of the Study:
- To investigate handgrip strength as a functional indicator of nutritional status in children with malnutrition.
- To compare muscle strength between malnourished children and healthy controls.
- To evaluate the response to nutritional therapy using muscle strength measurements.
Main Methods:
- Prospective controlled study involving 55 children with malnutrition and 50 controls (aged 3-17 years).
- Assessed anthropometric measurements, handgrip strength, and pinch grip strength.
- Standardized muscle strength values (SDS) and repeated measurements post-therapy.
Main Results:
- Malnourished children exhibited lower anthropometrics and reduced handgrip strength (p < 0.05).
- Age- and sex-adjusted handgrip strength SDS remained significantly lower in malnourished children.
- Nutritional therapy improved absolute strength, but SDS changes indicated variable recovery influenced by growth.
Conclusions:
- Handgrip strength reflects pediatric nutritional status, correlating with malnutrition independently of growth factors.
- It serves as a potential complementary functional marker for assessing children.
- Interpreting recovery requires consideration of normal growth, necessitating further large-scale studies.
Abstract:
Background/Objectives: Pediatric malnutrition is associated with loss of muscle mass and impaired physical function. While anthropometric measurements are widely used for diagnosis, functional indicators that reflect early changes in nutritional status are limited in children. Handgrip strength has been proposed as a simple and objective marker of muscle function; however, pediatric data remain scarce. Methods: In this prospective controlled study, 55 children aged 3-17 years diagnosed with malnutrition and 50 age- and sex-matched healthy controls were evaluated. Anthropometric measurements and muscle strength assessments, including handgrip and pinch grip strength, were performed in both groups. Muscle strength values were additionally converted to age- and sex-adjusted standard deviation scores (SDS). In the malnutrition group, measurements were repeated at 2 and 8 weeks following individualized nutritional therapy to assess treatment response. Results: Children with malnutrition had significantly lower body weight, body mass index, mid-upper arm circumference, triceps skinfold thickness, and lean body mass compared with controls (p < 0.05 for all). Both dominant and non-dominant handgrip strength values were also significantly reduced in the malnutrition group. When adjusted for age and sex, handgrip strength SDS values remained significantly lower in children with malnutrition, whereas pinch grip strength SDS values did not differ significantly between groups. During follow-up, nutritional therapy was associated with significant improvements in anthropometric parameters and absolute muscle strength measurements. However, SDS-based analyses demonstrated that these changes were not uniform across all parameters, suggesting that observed improvements may only partly exceed expected physiological growth. Conclusions: Handgrip strength appears to reflect nutritional status in children, and its association with malnutrition persists after adjustment for growth-related factors. These findings support its potential role as a complementary functional marker. However, longitudinal changes in standardized scores indicate that recovery is variable, and interpretation should consider the influence of normal growth and development. Further large-scale, age-standardized studies are needed to better define their role in clinical practice.
