{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T21:57:16Z","timestamp":1788904636231,"version":"build-2803163510"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,2,2]],"date-time":"2017-02-02T00:00:00Z","timestamp":1485993600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003958","name":"Stichting voor de Technische Wetenschappen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003958","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Handgrip strength (HGS) is used to identify individuals with low muscle strength (dynapenia). The influence of the number of attempts on maximal HGS is not yet known and may differ depending on age and health status. This study aimed to assess how many attempts of HGS are required to obtain maximal HGS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Three cohorts (939 individuals) differing in age and health status were included. HGS was assessed three times and explored as continuous and dichotomous variable. Paired <jats:italic>t<\/jats:italic>\u2010test, intraclass correlation coefficients (ICC) and Bland\u2013Altman analysis were used to test reproducibility of HGS. The number of individuals with misclassified dynapenia at attempts 1 and 2 with respect to attempt 3 were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Results showed the same pattern in all three cohorts. Maximal HGS at attempts 1 and 2 was higher than at attempt 3 on population level (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001 for all three cohorts). ICC values between all attempts were above 0.8, indicating moderate to high reproducibility. Bland\u2013Altman analysis showed that 41.0 to 58.9% of individuals had the highest HGS at attempt 2 and 12.4 to 37.2% at attempt 3. The percentage of individuals with a maximal HGS above the gender\u2010specific cut\u2010off value at attempt 3 compared with attempts 1 and 2 ranged from 0 to 50.0%, with a higher percentage of misclassification in middle\u2010aged and older populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Maximal HGS is dependent on the number of attempts, independent of age and health status. To assess maximal HGS, at least three attempts are needed if HGS is considered to be a continuous variable. If HGS is considered as a discrete variable to assess dynapenia, two attempts are sufficient to assess dynapenia in younger populations. Misclassification should be taken into account in middle\u2010aged and older populations.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12181","type":"journal-article","created":{"date-parts":[[2017,2,2]],"date-time":"2017-02-02T05:24:58Z","timestamp":1486013098000},"page":"466-474","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":148,"title":["Assessment of maximal handgrip strength: how many attempts are needed?"],"prefix":"10.1002","volume":"8","author":[{"given":"Esmee M.","family":"Reijnierse","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Section of Gerontology and Geriatrics VU University Medical Center  1007 MB Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nynke","family":"de Jong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Gerontology and Geriatrics VU University Medical Center  1007 MB Amsterdam The 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Nottingham  Royal Derby Hospital Centre Uttoxeter Rd, Derby DE22 3DT UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarianna","family":"Sipil\u00e4","sequence":"additional","affiliation":[{"name":"Gerontology Research Centre and Department of Health Sciences University of Jyv\u00e4skyl\u00e4  FI\u201040014 Jyv\u00e4skyl\u00e4 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauri","family":"Stenroth","sequence":"additional","affiliation":[{"name":"Department of Biology of Physical Activity University of Jyv\u00e4skyl\u00e4  FI\u201040014 Jyv\u00e4skyl\u00e4 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob C.","family":"van Lummel","sequence":"additional","affiliation":[{"name":"McRoberts BV  Raamweg 43 2596 HN The Hague The Netherlands"},{"name":"Department of Human Movement Sciences, MOVE Research Institute Amsterdam Vrije Universiteit  Van der Boechorststraat 7 1081 BT Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"Pijnappels","sequence":"additional","affiliation":[{"name":"McRoberts BV  Raamweg 43 2596 HN The Hague The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carel G.M.","family":"Meskers","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine VU University Medical Center  1007 MB Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea B.","family":"Maier","sequence":"additional","affiliation":[{"name":"Department of Human Movement Sciences, MOVE Research Institute Amsterdam Vrije Universiteit  Van der Boechorststraat 7 1081 BT Amsterdam The Netherlands"},{"name":"Department of Medicine and Aged Care, The Royal Melbourne Hospital The University of Melbourne  Parkville Victoria 3052 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