Date of Award

January 2019

Document Type

Thesis

Degree Name

Master of Science (MS)

Department

Kinesiology & Public Health Education

First Advisor

Grant R. Tomkinson

Abstract

Objective: To estimate national and international temporal trends in the handgrip strength of children and adolescents, and to examine relationships between trends in handgrip strength and trends in health-related and sociodemographic indicators.

Methods: Data were obtained in two ways: (a) through a systematic electronic database search for studies reporting on temporal trends in the handgrip strength of apparently healthy 9–17-year-olds, (b) pearling reference lists, topical systematic reviews and personal libraries, and (c) by examining large national fitness datasets suitable to temporal trends analysis. Sample-weighted temporal trends were estimated using best-fitting regression models relating the year of testing to mean handgrip strength. Post-stratified population-weighted mean changes in percent and standardized handgrip strength were estimated. Pearson’s correlations were used to quantify relationships between linear trends in handgrip strength and linear trends in health-related and sociodemographic indicators.

Results: Trend data from 22 studies/datasets representing 2,216,589 children and adolescents from 13 high-, five upper-middle-, and one low-income country collectively showed a moderate improvement in mean handgrip strength of 19.4% (95%CI: 18.4 to 20.4) or 3.8% per decade (95%CI: 3.6 to 4.0) between 1967 and 2017. The international rate of improvement in handgrip strength increased over time, doubling since the 1960s and 1970s. Improvements were larger for children (9–12 years) than adolescents (13–17 years) and similar for boys and girls. Trends differed in magnitude and direction between

countries, with most experiencing improvements. Trends in handgrip strength were negligibly-to-moderately related to trends in health-related and sociodemographic indicators.

Conclusions: There has been a meaningful improvement in the handgrip strength of children and adolescents since 1967, which has progressively increased in magnitude over time and is suggestive of a corresponding improvement in muscle and bone health. There is a need for improved international surveillance of handgrip strength, especially in children and adolescents from low- and middle-income countries, given the meaningful associations between handgrip strength and health-related outcomes.

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