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

Tomkinson GR, Lang JJ, Rubín L, McGrath R, Gower B, Boyle T, Klug MG, Mayhew AJ, Blake HT, Ortega FB, Cadenas-Sanchez C, Magnussen CG, Fraser BJ, Kidokoro T, Liu Y, Christensen K, Leong DP, Aadahl M, Abdin E, Alcazar J, Alenazi A, Alqahtani B, Amaral CDA, Amaral TL, Fernandes AA, Axelsson P, Baldwin JN, Bammann K, Barbosa AR, Bardo A, Bimali I, Bjerregaard P, Bobak M, Boreham CA, Bös K, Marins JCB, Burns J, Capkova N, Castillo-Martínez L, Chen LK, Choi SM, Choong RK, Confortin SC, Cooper C, Correa-Bautista JE, Cournil A, Cruz G, de Bruin ED, De Paz JA, Moreira BDS, Anjos LAD, Reyna MCE, Ferriolli E, Forrester G, Frolova E, Gebre AK, Ghaleb AM, Gill TK, Gondo Y, Gonzalez MC, Alvarez CG, Hannah MK, Harvey NC, Hogrel JY, Huemer MT, Iidaka T, Ingram LA, Jdanov DA, Keevil VL, Kemmler W, Kenny RA, Kim DY, Kivell TL, Kjær IG, Kluttig A, Kozakai R, Langer D, Larsen LA, Lee WJ, Leon DA, Lichtenstein E, Little BB, Lourenço RA, Malhotra R, Malina RM, Matsumoto K, Mazor-Karsenty T, McKay MJ, McLoughlin S, Mensegere AL, Mohammadian M, Moreira VG, Murayama H, Murray A, Neri AL, Niessner C, Othón GN, Olveira G, Orchard SG, Pajak A, Park CW, Pasco JA, Reyes ME, Pereira LSM, Peters A, Poon ETC, Portela MC, Pratt J, Ramírez-Vélez R, Rodríguez-García W, Ryan J, San-Martín MA, Sánchez-Torralvo FJ, Saremi M, Schmidt-Trucksäss A, Seino S, Shah SA, Sim M, Strand BH, Subramaniam M, Suetta C, Sui SX, Sundarakumar JS, Suzuki K, Tamosiunas A, Tan MP, Taniguchi Y, Thorand B, Turusheva A, Tveter AT, Wagner J, Wang D, Warden SJ, Wearing J, Wee SL, Westbury LD, Wiśniowska-Szurlej A, Woll A, Yoshimura N, Yu R (2025)

Publication Type: Journal article, Review article

Publication year: 2025

Journal

Book Volume: 14

Article Number: 101014

DOI: 10.1016/j.jshs.2024.101014

Abstract

Background: Muscular strength is a powerful marker of current health status and robust predictor of age-related disease and disability. Handgrip strength (HGS) using isometric dynamometry is a convenient, feasible, and widely used method of assessing muscular strength among people of all ages. While adult HGS norms have been published for many countries, no study has yet synthesized available data to produce international norms. The objective of this study was to generate international sex- and age-specific norms for absolute and body size-normalized HGS across the adult lifespan. Methods: Systematic searches were conducted in 6 databases/web search engines (MEDLINE, SPORTDiscus, Embase, Web of Science, CINAHL, and Google Scholar) up to December 1, 2023. We included full-text peer-reviewed observational studies that reported normative HGS data for adults aged ≥20 years by sex and age. Pseudo data were generated using Monte Carlo simulation following harmonization for methodological variation. Population-weighted Generalized Additive Models for Location, Scale, and Shape were used to develop sex- and age-specific norms for absolute HGS (kg) and HGS normalized by height (Ht, m) squared (i.e., HGS/Ht² in kg/m²). Norms were tabulated as percentile values (5th to 95th) and visualized as smoothed percentile curves. Results: We included data from 100 unique observational studies representing 2,405,863 adults (51.9% female) aged 20 to 100+ years from 69 countries and regions tested from the year 2000 onward. On average, absolute and normalized HGS values negligibly improved throughout early adulthood, peaked from age 30–39 years (at 49.7 kg (males) and 29.7 kg (females) for absolute HGS or 16.3 kg/m² (males) and 11.3 kg/m² (females) for HGS/Ht²), and declined afterwards. The age-related decline in HGS accelerated from middle to late adulthood and was slightly larger for males than for females during middle adulthood. Conclusion: This study provides the world's largest and most geographically comprehensive international norms for adult HGS by sex and age. These norms have utility for global peer-comparisons, health screening, and surveillance.

Authors with CRIS profile

Involved external institutions

Universität Basel Switzerland (CH) University of Louisville (UofL) United States (USA) (US) Hospital Regional de Málaga Spain (ES) Monash University Australia (AU) Jagiellonian University / Uniwersytet Jagielloński (UJ) Poland (PL) California State University Sacramento (CSUS) United States (USA) (US) Deakin University Australia (AU) Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt (HMGU) / Helmholtz Munich Germany (DE) The Chinese University of Hong Kong (CUHK) China (CN) Oswaldo Cruz Foundation / Fundação Oswaldo Cruz (FIOCRUZ) Brazil (BR) Universidade Estadual de Campinas (UNICAMP) / University of Campinas Brazil (BR) University College Dublin (UCD) Ireland (IE) Tokyo Metropolitan Institute for Geriatrics and Gerontology Japan (JP) Hospital Universitario de Navarra Spain (ES) Universidad Austral de Chile Chile (CL) National Autonomous University of Mexico / Universidad Nacional Autónoma de México (UNAM) Mexico (MX) University Kebangsaan Malaysia Medical Centre / Pusat Perubatan Universiti Kebangsaan Malaysia Malaysia (MY) Indian Institute of Science (IISc) India (IN) Shahid Beheshti University of Medical Sciences Iran, Islamic Republic of (IR) Edith Cowan University Australia (AU) Juntendo University Japan (JP) Federal University of Santa Catarina / Universidade Federal de Santa Catarina (UFSC) Brazil (BR) Norwegian Institute of Public Health (NIPH) / Folkehelseinstituttet Norway (NO) Institute of Mental Health Singapore (SG) Kathmandu University (KU) / काठमाडौं विश्वविद्यालय Nepal (NP) Copenhagen University Hospital Denmark (DK) University of Southern Denmark / Syddansk Universitet Denmark (DK) University College London (UCL) United Kingdom (GB) Karlsruhe Institute of Technology (KIT) Germany (DE) University of Tokyo Japan (JP) Lithuanian University of Health Sciences / Lietuvos sveikatos mokslų universitetas (LSMU) Lithuania (LT) University of Malaya (UM) / Universiti Malaya Malaysia (MY) North-Western State Medical University named after I.I. Mechnikov / Санкт-Петербургская государственная медицинская академия (СЗГМУ) имени И. И. Мечникова Russian Federation (RU) Diakonhjemmet Hospital Norway (NO) Shanghai University of Sport China (CN) Indiana University Indianapolis (IUI) United States (USA) (US) Duale Hochschule Baden-Württemberg (DHBW) / Baden-Wuerttemberg Cooperative State University Germany (DE) Singapore Institute of Technology Singapore (SG) University of Southampton United Kingdom (GB) Uniwersytet Rzeszowski Poland (PL) Trinity College Dublin Ireland (IE) Universidade Federal de Viçosa (UFV) Brazil (BR) Nippon Sport Science University / 日本体育大学 Japan (JP) St. Jude Children’s Research Hospital United States (USA) (US) National Institute of Public Health (NIPH) / Státní Zdravotní Ústav (SZÙ) Czech Republic (CZ) Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Mexico (MX) Frederiksberg Hospital Denmark (DK) Universidade do Extremo Sul Catarinense Brazil (BR) University of Cundinamarca Colombia (CO) Institut de recherche pour le développement (IRD) France (FR) University of the Philippines Diliman (UP Diliman) Philippines (PH) Eidgenössische Technische Hochschule Zürich (ETHZ) / Swiss Federal Institute of Technology in Zurich Switzerland (CH) Universidad de León Spain (ES) Universidade Federal de Minas Gerais (UFMG) Brazil (BR) Fluminense Federal University / Universidade Federal Fluminense (UFF) Brazil (BR) Universidad Autónoma de Nuevo León Mexico (MX) University of São Paulo / Universidade de São Paulo (USP) Brazil (BR) Universidad de Castilla-La Mancha (UCLM) Spain (ES) Prince Sattam Bin Abdulaziz University (PSAU) / جامعة سطام بن عبدالعزيز Saudi Arabia (SA) Acre Federal Institute of Education, Science and Technology / Instituto Federal de Educação, Ciência e Tecnologia do Acre (IFAC) Brazil (BR) Federal University of Acre / Universidade Federal do Acre (UFAC) Brazil (BR) Universität Bremen Germany (DE) University of South Australia Australia (AU) Technical University of Liberec (TUL) Czech Republic (CZ) Alfaisal University Saudi Arabia (SA) University of Adelaide Australia (AU) Federal University of Pelotas / Universidade Federal de Pelotas (UFPEL) Brazil (BR) University of North Dakota United States (USA) (US) McMaster University Canada (CA) University of Glasgow United Kingdom (GB) Universidad de Granada Spain (ES) Institut de Myologie France (FR) Rio de Janeiro State University / Universidade do Estado do Rio de Janeiro (UERJ) Brazil (BR) Duke-NUS Medical School / 杜克—国大医学研究生院 Singapore (SG) Federal Center for Technological Education of Minas Gerais (CEFET-MG) / Centro Federal de Educação Tecnológica de Minas Gerais Brazil (BR) Sahlgrenska University Hospital / Sahlgrenska Universitetssjukhuset Sweden (SE) Osaka University / 大阪大学 Japan (JP) Taipei Veterans General Hospital / 台北榮民總醫院 Taiwan (TW) University of Macau (UM) / Universidade de Macau / 澳門大學 Macao (MO) University of Sussex United Kingdom (GB) Kerman University of Medical Sciences / Kerman Medical University / دانشگاه علوم پزشکی کرمان Iran, Islamic Republic of (IR) Hennepin Healthcare Research Institute (HHRI) United States (USA) (US) Max-Planck-Institut für demografische Forschung / Max Planck Institute for Demographic Research (MPIDR) Germany (DE) University of Cambridge United Kingdom (GB) Universidad de Sonora Mexico (MX) Korea National Sport University Korea, Republic of (KR) Max Planck Institute for Evolutionary Anthropology / Max-Planck-Institut für evolutionäre Anthropologie Germany (DE) University of Agder / Universitetet i Agder / Agderin yliopisto Norway (NO) Martin-Luther-Universität Halle-Wittenberg (MLU) Germany (DE) Hokusho University / 北翔大学 Japan (JP) National Yang Ming Chiao Tung University Taiwan (TW) London School of Hygiene and Tropical Medicine United Kingdom (GB)

How to cite

APA:

Tomkinson, G.R., Lang, J.J., Rubín, L., McGrath, R., Gower, B., Boyle, T.,... Yu, R. (2025). 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. Journal of Sport and Health Science, 14. https://doi.org/10.1016/j.jshs.2024.101014

MLA:

Tomkinson, Grant R., 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." Journal of Sport and Health Science 14 (2025).

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