Low Handgrip Strength in COPD Associated With Flare-ups

Low Handgrip Strength Is A Marker of Frailty 

Background: Frailty occurs with aging. Two components of frailty are muscle weakness and unintentional weight loss of more than 10 pounds. Handgrip strength is a measure muscle weakness and is a strong predictor of all cause mortality in the general population.
Device to measure handgrip strength

Device to measure handgrip strength

However, the importance of strength of the hand muscles in those with COPD is unknown.
D.r Martinez is the first author of study of handgrip strength

Dr. Carlos Martinez is Assistant Professor of Medicine at the University of Michigan School of Medicine

Study: Dr. Carlos Martinez and colleagues evaluated handgrip strength in 272 patients with COPD who were participants in a study called COPDGene funded by the National Institutes of Health. Subjects recorded the number of COPD flare-ups (exacerbations) in the past year and during 2 years of follow-up. The study was published in the November 2017 issue of the Annals of the American Thoracic Society (volume 14; pages 1638-1645). Results: Subjects: Average age was 65 years; 45% were women; and 8% were African-American. During the previous year, 31% had a flare-up. Handgrip Strength: 65% of the subjects had low handgrip strength compared with 15% in those living in a community without COPD. It was associated with lung function (amount of air exhaled in one second – called FEV1), shortness of breath, and distance walked in six minutes (called 6 minute walk test). The authors calculated that for every 1-kilogram decrease in handgrip strength, there was a 5% higher risk of having a flare-up. Conclusions: Low muscle strength measured by handgrip testing was associated with a higher risk of a flare-up. My Comments: Low handgrip strength is a marker of reduced physical performance in the elderly and has been shown to be a risk factor for all-cause death as well as cardiovascular mortality.
Resistance training can increase muscle strength

Woman with COPD doing arm curls with hand weights.

These findings of the study support the need for early identification of  muscle weakness in those with COPD. In addition, the results suggest that such individuals should be participate in physical therapy and/or in pulmonary rehabilitation. Resistance training 2 -3 times a week using light weights or stretch bands can increase general muscle strength including the muscles used for hand gripping.

Donald A. Mahler, M.D. is Emeritus Professor of Medicine at Geisel School of Medicine at Dartmouth in Hanover, New Hampshire. He works as a pulmonary physician at Valley Regional Hospital in Claremont, NH, where he is Director of Respiratory Services.