Date of Award

January 2022

Document Type


Degree Name

Master of Science (MS)


Education, Health & Behavior Studies

First Advisor

Grant R. Tomkinson


Background: 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 measured using handheld dynamometry. While several studies have examined relationships between HGS asymmetry and HRQOL, few have used nationally-representative data, and none have used Canadian data. The aim of this study, therefore, was 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 and 6 (2016–17 and 2018–19) of the Canadian Health Measure Surveys (CHMS) dataset 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.

Results: This study showed 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: These findings may be important for clinical screening and population health surveillance. We recommend that HGS asymmetry be included as a standard part of clinical practice and continue to be used in national health surveillance systems.

Keywords: Hand grip strength, Grip strength, Hand grip asymmetry, Health related quality of life (HRQOL), Quality of life (QOL), Well-being, Health Utility Index (HUI), Canadian, Canada