Date of Award

January 2022

Document Type


Degree Name

Master of Science (MS)


Kinesiology & Public Health Education

First Advisor

Grant R. Tomkinson


Background: Hand-grip strength (HGS) is a convenient, valid, and reliable measure of overall muscle strength that is significantly related to current and future health. HGS asymmetry is an additional aspect of muscle function that can also be measured using handheld dynamometry. The aim of this study was to examine associations between HGS asymmetry and multimorbidity in a nationally representative sample of Canadian adults aged 40 years or older. Methods: A secondary analysis of cross-sectional data was performed on adults aged 40-79 years from six cycles (2007- 2017) of the Canadian Health Measures Survey (CHMS). HGS was assessed using handheld dynamometry, with HGS asymmetry calculated as the ratio of the maximum scores for the strongest and weakest hands. Multimorbidity was defined as the presence of two or more of the following chronic conditions: arthritis, mental disorder (mood disorder and/or anxiety), asthma, diabetes mellitus, heart disease, chronic obstructive pulmonary disease (COPD), cancer, or stroke. Crude and covariate-adjusted logistic regression models were used to quantify the relationship between HGS asymmetry and multimorbidity. Results: HGS asymmetry was significantly associated with multimorbidity in Canadian adults. Relative to individuals without asymmetry (<11% asymmetry), adults with ≥21% asymmetry had 1.34 greater odds for multimorbidity (95% CI: 1.01–1.79) after adjustment for covariates. When stratified by sex, significant associations were found only for women. Women with ≥21% HGS asymmetry had 1.55 (95% CI: 1.09–2.20) greater odds for multimorbidity. Conclusion: These findings indicate that HGS asymmetry is associated with multimorbidity in Canadian women and suggest that HGS asymmetry has potential utility for clinical screening and population health surveillance for women at risk of multimorbidity.