Reduced Calf Muscle Pump Function Is Not Explained by Hand Grip Strength Measurements

Objective Reduced calf muscle pump function (CPF) is an independent risk factor for venous thromboembolism and mortality. We aimed to evaluate the relationship between hand grip strength (HGS) and CPF. Method Patients referred to the Gonda Vascular Laboratory for non-invasive venous studies were identified and consented. Subjects underwent standard venous air plethysmography protocol. CPF (ejection fraction) was measured in each lower extremity of ambulatory patients by comparing refill volume after ankle flexes and passive refill volumes. The cut-off for reduced calf pump function (rCPF) was defined as an ejection fraction below 45%. Maximum HGS bilaterally was obtained (3 trials per hand) using a dynamometer. HGS and CPF were compared (right hand to calf, left hand to calf) and the correlation between the measures was evaluated. Result 115 patients (mean age 59.2 (SD 17.4) years, 67 females, mean BMI 30.83 (SD, 6.46)) were consented and assessed for HGS and CPF. Reduced CPF was observed in 53 (46%) right legs and 67 (58%) left legs. CPF was reduced bilaterally in 45 (39%) and unilaterally in 30 (26%) subjects. HGS was reduced bilaterally in 74 (64.3%), unilaterally reduced in 23 (20%), and normal in 18 (15.7%) subjects. Comparing each hand/calf pair, no significant correlations were seen between HGS and CPF. The Spearman's rank correlation coefficients test yielded values of 0.16 for the right side and 0.10 for the left side. Conclusion There is no significant correlation between HGS and CPF, demonstrating that HGS measurements are not an acceptable surrogate for rCPF indicating different pathophysiologic mechanisms for each process.