Hand Grip Dynamometry as Prognostic and Predictive Marker in Older Patients With Cancer

Abstract

Muscle strength as measured by hand grip dynamometer is a simple, fast and validated test which correlates well with other measures of functional capacity including six-minute walk test, barthel index and independence with activities of daily living. Elderly patients with advanced cancer represent a subset of population that is specially predisposed to loss of muscle strength. Low muscle strength has also been associated with poor quality of life, increased cardiovascular mortality, non-cardiovascular mortality and all-cause mortality, which is independent of diagnosis. This could have important implications for future studies which may use hand grip strength as the sole measure of functional capacity in predicting morbidity and mortality and avoiding complex questionnaires and other time-consuming tests. Jamar hand dynamometer is a commonly used device and is considered an industry standard in current practice. Periodic assessment may help in predicting at risk population and early referral to strength training program may help obviate the negative health effects of low muscle strength. Despite its ease and predictive power however, hand grip dynamometry remains grossly underutilized. Increased awareness of this simple technology will go a long way in making cost effective health related treatment plans for future patients with advanced cancer.