This is a preview and has not been published.

Reference Values for Maximal Isometric Handgrip and Pinch Strength in Healthy Italian Adults Without Occupational Biomechanical Overload

Authors

  • Emma Sala Unit of Occupational Health, Hygiene, Toxicology and Prevention, ASST Spedali Civili di Brescia, 25123 Brescia, Italy Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy
  • Nicola Riolfi Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy
  • Alessandro De Bellis Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy
  • Andrea Bisioli Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy
  • Cesare Tomasi Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy
  • Francesco Romagnoli Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy
  • Giuseppe De Palma Unit of Occupational Health, Hygiene, Toxicology and Prevention, ASST Spedali Civili di Brescia, 25123 Brescia, Italy and Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy

Keywords:

handgrip strength; pinch strength; reference values; occupational health; biomechanical load

Abstract

 

Background: Handgrip strength (HGS) and pinch strength are key indicators of hand function with relevant clinical and ergonomic implications. In Italy, normative reference values based on combined measurements of grip and pinch strength in healthy adults not exposed to upper-limb biomechanical overload are currently lacking. The primary aim of this cross-sectional study was to provide descriptive reference values for HGS and three pinch types, stratified by sex and age group, in a healthy Italian adult population (18–65 years) not exposed to occupational biomechanical overload. The secondary aim was to investigate the influence of sex, age, body mass index (BMI), and hand dominance, as well as the relationships among strength measures.

Methods: A total of 813 participants (319 men and 494 women) were evaluated. Measurements were performed using a calibrated Baseline® hand dynamometer and pinch gauge according to the standardized protocol of the American Society of Hand Therapists (ASHT).

Results: Men showed higher strength values than women across all measures. The association between body mass index (BMI) and strength was more pronounced and consistent in women than in men, reaching statistical significance only for selected pinch measures in males. Strength values showed a non-linear distribution across age groups, with peak levels observed between 30 and 49 years in men and between 40 and 49 years in women. Hand dominance showed a selective effect in both sexes, influencing specific pinch tasks but not handgrip strength.

Conclusions: This study provides the first national joint normative dataset for intergrip and pinch strength in healthy Italian adults aged 18–65 years not exposed to occupational biomechanical overload. These findings may support clinical and occupational assessments and contribute to the development of broader Italian normative reference tables.

References

1. Schlüssel MM, dos Anjos LA, de Vasconcellos MTL, Kac G. Reference values of handgrip dyna-mometry of healthy adults: a population-based study. Clin Nutr. 2008;27(4):601–607. doi:10.1016/j.clnu.2008.04.004.

2. Mitsionis G, Pakos EE, Stafilas KS, Paschos N, Papakostas T, Beris AE. Normative data on hand grip strength in a Greek adult population. Int Orthop. 2009;33(3):713–717. doi:10.1007/s00264-008-0551-x.

3. Cuenca-Garcia M, et al. Reliability of field-based fitness tests in adults: a systematic review. Sports Med. 2022;52(8):1961–1979. doi:10.1007/s40279-021-01635-2.

4. Suni JH, et al. Safety and feasibility of a health-related fitness test battery for adults. Phys Ther. 1998;78(2):134–148. doi:10.1093/ptj/78.2.134.

5. Bohannon RW. Hand-grip dynamometry predicts future outcomes in aging adults. J Geriatr Phys Ther. 2008.

6. Cruz-Jentoft AJ, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31. doi:10.1093/ageing/afy169.

7. Fried LP, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–M156. doi:10.1093/gerona/56.3.M146.

8. Bohannon RW. Hand-grip dynamometry predicts future outcomes in aging adults. J Geriatr Phys Ther. 2008;31(1):3-10. doi: 10.1519/00139143-200831010-00002. PMID: 18489802.

9. Torri D, Sala E, Orizio C, Apostoli P. Stima della presa in pinch: approfondimento degli aspetti metodologici ed applicativi mediante l'impiego di un nuovo apparato portatile, P force Met [Pinch assessing in bio mechanical analysis: methodological and applicative aspects dealt by using the new P force Met portable instrument]. G Ital Med Lav Ergon. 2011 Jan-Mar;33(1):63-73. Italian. PMID: 21425633.

10. Tomkinson GR, et al. 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. J Sport Health Sci. 2024;14:101014. doi:10.1016/j.jshs.2024.101014.

11. Lam NW, Goh HT, Kamaruzzaman SB, Chin AV, Poi PJH, Tan MP. Normative data for hand grip strength and key pinch strength stratified by age and gender for a multiethnic Asian population. Singapore Med J. 2016;57(10):578–584. doi:10.11622/smedj.2015164.

12. Werle S, Goldhahn J, Drerup S, Simmen BR, Sprott H, Herren DB. Age- and gender-specific nor-mative data of grip and pinch strength in a healthy adult Swiss population. J Hand Surg Eur. 2009;34(1):76–84. doi:10.1177/1753193408096763.

13. Wang YC, Bohannon RW, Li X, Sindhu B, Kapellusch J. Hand-grip strength: normative reference values and equations for individuals 18 to 85 years of age residing in the United States. J Orthop Sports Phys Ther. 2018;48(9):685–693. doi:10.2519/jospt.2018.7851.

14. Ekşioğlu M. Normative static grip strength of the population of Turkey: effects of various factors and comparison with international norms. Appl Ergon. 2016;52:8–17. doi:10.1016/j.apergo.2015.06.023.

15. Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S. Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil. 1985 Feb;66(2):69-74. PMID: 3970660..

16. Macdermid JC, Fehr L, Lindsay K. The effect of physical factors on grip strength and dexterity. Br J Hand Ther. 2002;7(4):112–118. doi:10.1177/175899830200700401.

17. Xiao G, Lei L, Dempsey PG, Lu B, Liang Y. Isometric muscle strength and anthropometric charac-teristics of a Chinese sample. Int J Ind Ergon. 2005;35(7):674–679. doi:10.1016/j.ergon.2005.02.003.

18. Kamarul T, Ahmad TS, Loh WY. Hand grip strength in the adult Malaysian population. J Orthop Surg (Hong Kong). 2006;14(2):172–177. doi:10.1177/230949900601400213.

19. Bohannon RW, Peolsson A, Massy-Westropp N, Desrosiers J, Bear-Lehman J. Reference values for adult grip strength measured with a Jamar dynamometer: a descriptive meta-analysis. Physiotherapy. 2006;92(1):11–15. doi:10.1016/j.physio.2005.05.003.

20. Anakwe RE, Huntley JS, McEachan JE. Grip strength and forearm circumference in a healthy pop-ulation. J Hand Surg Eur. 2007;32(2):203–209. doi:10.1016/j.jhsb.2006.11.003.

21. Shim JH, et al. Normative measurements of grip and pinch strengths of the 21st century Korean population. Arch Plast Surg. 2013;40(1):52–56. doi:10.5999/aps.2013.40.1.52.

22. Michael AI, Iyun AO, Olawoye OA, Ademola SA, Nnabuko RE, Oluwatosin OM. Normal values of key pinch strength in a healthy Nigerian population. Ann Ib Postgrad Med. 2015;13(2):84.

23. Dodds RM, et al. Grip strength across the life course: normative data from twelve British studies. PLoS One. 2014;9(12). doi:10.1371/journal.pone.0113637.

24. Lo VEW, Chiu YC, Tu HH, Liu CW, Yu CY. A pilot study of five types of maximum hand strength among manufacturing industry workers in Taiwan. Int J Environ Res Public Health 2019;16(23):4742. doi:10.3390/ijerph16234742.

25. Alrashdan A, Ghaleb AM, Almobarek M. Normative static grip strength of Saudi Arabia’s popula-tion and factors influencing grip strength. Healthcare. 2021;9(12):1647. doi:10.3390/healthcare9121647.

26. Luna-Heredia E, Martín-Peña G, Ruiz-Galiana J. Handgrip dynamometry in healthy adults. Clin Nutr. 2005;24(2):250–258. doi:10.1016/j.clnu.2004.10.007.

27. Massy-Westropp NM, Gill TK, Taylor AW, Bohannon RW, Hill CL. Hand grip strength: age and gender stratified normative data in a population-based study. BMC Res Notes. 2011;4:127. doi:10.1186/1756-0500-4-127.

28. He H, et al. Normative values of hand grip strength in a large unselected Chinese population: evi-dence from the China National Health Survey. J Cachexia Sarcopenia Muscle. 2023;14(3):1312–1321. doi:10.1002/jcsm.13223.

29. Perna FM, Coa K, Troiano RP, Lawman HG, Wang CY, Li Y, Moser RP, Ciccolo JT, Comstock BA, Kraemer WJ. Muscular Grip Strength Estimates of the U.S. Population from the National Health and Nutrition Examination Survey 2011-2012. J Strength Cond Res. 2016 Mar;30(3):867-74. doi: 10.1519/JSC.0000000000001104. PMID: 26196662; PMCID: PMC7197498.Larson CC, Ye Z. De-velopment of an updated normative data table for hand grip and pinch strength: a pilot study. Comput Biol Med. 2017;86:40–46. doi:10.1016/j.compbiomed.2017.01.021.

30. Larson CC, Ye Z. Development of an updated normative data table for hand grip and pinch strength: a pilot study. Comput Biol Med. 2017;86:40–46. doi:10.1016/j.compbiomed.2017.01.021. 30

31. Dodds RM, Syddall HE, Cooper R, Kuh D, Cooper C, Sayer AA. Global variation in grip strength: a systematic review and meta-analysis of normative data. Age Ageing. 2016;45(2):209–216. doi:10.1093/ageing/afv192.

32. Leong DP, et al. Reference ranges of handgrip strength from 125,462 healthy adults in 21 countries: the PURE study. J Cachexia Sarcopenia Muscle. 2016;7(5):535–546. doi:10.1002/jcsm.12112.

33. Landi F, et al. Normative values of muscle strength across ages in a real-world population: results from the Longevity Check-up 7+ project. J Cachexia Sarcopenia Muscle. 2020;11(6):1562–1569. doi:10.1002/jcsm.12610.

34. Dottor A, Sansone LG, Battista S, Mori L, Testa M. Flexion-extension strength of the index-thumb system in the Italian population: a cross-sectional study to gather normative data. J Hand Ther. 2023;36(1):85–96. doi:10.1016/j.jht.2021.05.004.

35. American Society of Hand Therapists. Clinical Assessment Recommendations. 3rd ed. Chicago: American Society of Hand Therapists; 2015.

36. Sidarta A, et al. Establishing normative pinch and grip strengths across adult age groups in Singa-pore. BMC Sports Sci Med Rehabil. 2025;17(1):84. doi:10.1186/s13102-025-01140-3.

37. Härkönen R, Piirtomaa M, Alaranta H. Grip strength and hand position of the dynamometer in 204 Finnish adults. J Hand Surg Br. 1993;18(1):129–132. doi:10.1016/0266-7681(93)90212-X.

38. Yim SY, Cho JR, Lee IY. Normative data and developmental characteristics of hand function for elementary school children in Suwon area of Korea: grip, pinch and dexterity study. J Korean Med Sci. 2003;18(4):552–558. doi:10.3346/jkms.2003.18.4.552.

39. Sayadizadeh M, Daliri M, Sadeghi M, Azimi MA, Mozafari JK, Moradi A. Normative values of grip and pinch strength and their predictor factors: PERSIAN cohort study of healthcare staff. Int Orthop. 2025;49(3):549–557. doi:10.1007/s00264-025-06409-3.

Downloads

Issue

Section

Original articles

How to Cite

1.
Sala E, Riolfi N, De Bellis A, et al. Reference Values for Maximal Isometric Handgrip and Pinch Strength in Healthy Italian Adults Without Occupational Biomechanical Overload. Med Lav. 117(2):18834. doi:10.23749/mdl.2026.18834