Handgrip Strength Asymmetry Is Associated With Health-Related Quality Of Life Among Canadian Adults

Health-related quality of life (HRQOL), a measure of perceived quality of health, is significantly related to current and future health. Handgrip strength (HGS) asymmetry is an aspect of muscle function that can be assessed using a hand dynamometry. While several studies have found relationships between HGS asymmetry and HRQOL, few have used nationally representative data, and none have used Canadian data. PURPOSE: To examine the association between HGS asymmetry and HRQOL in a nationally representative sample of Canadian adults. METHODS: A secondary analysis of cross-sectional data from cycles 5 (2016-17) and 6 (2018-19) of the Canadian Health Measure Survey was performed for adults aged 18-79 years. HGS asymmetry was calculated as the ratio between the maximum HGS scores for the strongest and weakest hands. HRQOL was measured using the Health Utility Index. Crude and covariate-adjusted logistic regression models were used to quantify the relationships between HGS asymmetry and HRQOL. The adjusted models included age, sex, race, marital status, education level, BMI, self-reported general health, and self-reported mental health as covariates. SAS (v9.4, SAS Institute, Cary, NC, USA) was used for all analyses. RESULTS: We found that HGS asymmetry was significantly associated with poor HRQOL in Canadian adults. Relative to individuals without asymmetry, adults with ≥21% asymmetry had 1.80 (95%CI: 1.26–2.56) greater odds for poor overall HRQOL after adjustment for covariates. In addition, adults with ≥21% HGS asymmetry had 3.29 (95%CI: 1.37–7.91) greater odds for poor mobility. CONCLUSIONS: We found that HGS asymmetry was associated with poor HRQOL among Canadian adults. Our findings suggest that HGS asymmetry can help with clinical screening, and it could potentially help inform appropriate referrals that may decelerate the loss of physical function. Hand dynamometers are an acceptable and feasible tool to assess bilateral strength asymmetry, which should be included as a standard part of clinical practice and continue to be used in population health surveillance.