Clinical importance of simple muscular fitness tests to predict long-term health conditions: a systematic review and meta-analysis of 94 cohort studies

Objective: To examine the predictive validity of field-based muscular strength tests in relation to incident long-term health conditions among adults.

Design: Systematic review and meta-analysis.

Data sources: PubMed, Web of Science, SPORTDiscus, Scopus, CINAHL, Epistemonikos and Google Scholar.

Eligibility criteria: Cohort studies examining the predictive value of validated and/or reliable field-based muscular strength tests in relation to long-term health conditions in adults aged ≥18 years.

Results: A total of 155 studies were included with 94 included in the meta-analysis. Adults with the highest (vs lowest) handgrip strength levels had a lower risk of multiple long-term health conditions (all p<0.05), including cardiovascular diseases (OR=0.73; 95% CI 0.67 to 0.80), type 2 diabetes mellitus (OR=0.79; 95% CI 0.68 to 0.91), musculoskeletal impairment (OR=0.65; 95% CI 0.56 to 0.76), disability (OR=0.57; 95% CI 0.47 to 0.70), anxiety (OR=0.79; 95% CI 0.63 to 0.99), depression (OR=0.70; 95% CI 0.63 to 0.78), cognitive decline (OR=0.57; 95% CI 0.44 to 0.75), dementia (OR=0.62; 95% CI 0.53 to 0.73) and Parkinson’s disease (OR=0.53; 95% CI 0.31 to 0.91). A 5 kg increase in handgrip strength was associated with a lower risk of developing most of these long-term health conditions. In turn, adults with the best (vs worst) performance on the 5-repetition chair-stand test had a lower risk of type 2 diabetes mellitus (OR=0.80; 95% CI 0.72 to 0.88), musculoskeletal impairment (OR=0.52; 95% CI 0.37 to 0.74), disability (OR=0.58; 95% CI 0.41 to 0.82), depression (OR=0.63; 95% CI 0.42 to 0.95), and dementia (OR=0.68; 95% CI 0.54 to 0.85). Every 1 s decrease was associated with 0.94 lower odds of musculoskeletal impairment. The overall quality of the evidence ranged from very low to moderate, indicating limited to moderate confidence in the results.