Handgrip strength does not represent an appropriate measure to evaluate changes in muscle strength during an exercise intervention program in frail older people

Although handgrip strength is considered a strong predictor of negative health outcomes, it is unclear whether handgrip strength represents a useful measure to evaluate changes in muscle strength following resistance-type exercise training in older people. We assessed whether measuring handgrip strength provides proper insight in the efficacy of resistance-type exercise training to increase muscle mass, strength, and physical performance in frail older people. Methods: Prefrail and frail older people (≥ 65 y) were either conducting a 24-week resistance-type exercise training or no exercise training. Before, during, and after the intervention, handgrip strength (JAMAR), lean body mass (DXA), leg strength (1-RM), and physical performance (SPPB) were assessed. Results: Handgrip strength correlated with appendicular lean mass (r = 0.68; p < .001) and leg strength (r = 0.67; p < .001). After 24 weeks of whole body resistance-type exercise training, leg extension strength improved significantly better when compared with the control group (57 ± 2–78 ± 3 kg vs 57 ± 3–65 ± 3 kg: p < .001). Moreover, physical performance improved significantly more in the exercise group (8.0 ± 0.4–9.3 ± 0.4 points) when compared with the control group (8.3 ± 0.4–8.9 ± 0.4 points: p < .05). These positive changes were not accompanied with any significant changes in handgrip strength (26.3 ± 1.2–27.6 ± 1.2 kg in the exercise group vs 26.6 ± 1.2–26.3 ± 1.3 kg in the control group: p = .71). Conclusion: Although handgrip strength strongly correlates with muscle mass and leg strength in frail older people, handgrip strength does not provide a valid means to evaluate the efficacy of exercise intervention programs to increase muscle mass or strength in an older population.