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Foley RCA, Callaghan DH, Forman GN, Graham JD, Holmes MWR, La Delfa NJ. A comprehensive scoping review and meta-analysis of upper limb strength asymmetry. Sci Rep 2025; 15:4636. [PMID: 39920213 PMCID: PMC11806048 DOI: 10.1038/s41598-025-87413-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Accepted: 01/20/2025] [Indexed: 02/09/2025] Open
Abstract
The "10% rule" of handedness asserts the dominant hand is 10% stronger than the non-dominant hand. Primarily derived from handgrip data, it is unclear if a generalized asymmetry exists across the upper limb. Understanding how strength asymmetry may be affected by handedness, sex, and exertion type has important implications for ergonomics design, sports performance, and clinical rehabilitation. The purpose of this study was to systematically synthesize currently available evidence examining upper limb strength asymmetry. 10,061 results were retrieved, and 174 studies remained after title/abstract screening. 87 studies were synthesized. Results are compiled by exertion type and manner of asymmetry comparison (i.e. right/left, dominant/non-dominant). Asymmetry ratios were calculated to examine the effects of handedness, exertion side, arm region, and sex. Strength differences were most frequently reported for grip exertions (n = 49). 25 studies reported other joint strength asymmetries. Overall, the right limb was 6.7% stronger than the left limb (n = 9342) and the dominant limb was 11.6% stronger than the non-dominant limb (n = 9327), though strength asymmetry varied across joints and movements (2.1% to 19.5%). This research demonstrates that the 10% rule is a good approximation for upper limb strength asymmetry. However, several factors, including joint, movement type, and sex, can affect this relationship.
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Affiliation(s)
- Ryan C A Foley
- Department of Kinesiology, Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Danny H Callaghan
- Department of Kinesiology, Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Garrick N Forman
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St Catharine's, ON, Canada
| | - Jeffrey D Graham
- Department of Kinesiology, Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St Catharine's, ON, Canada
| | - Michael W R Holmes
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St Catharine's, ON, Canada
| | - Nicholas J La Delfa
- Department of Kinesiology, Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada.
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Mallada NP, Beltrán MJM, Nuño MAS, Ribeiro ASF, Villa IDM, Molina CM, Tabares AME, Santamaría AP, Sánchez HL. Biomechanical Factors Predisposing to Knee Injuries in Junior Female Basketball Players. Sports (Basel) 2024; 12:60. [PMID: 38393280 PMCID: PMC10891574 DOI: 10.3390/sports12020060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/18/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
This cross-sectional observational study aims to determine isokinetic normality data at different speeds, and isometric data of ankle and knee joints, in healthy basketball players aged 15-16 years old. The participants were recruited through non-probabilistic convenience sampling. Sociodemographic, anthropometric, and biomechanical variables were collected. The study involved 42 participants. Right-leg dominance was higher in women (85.7%) than in men (78.6%). Men had a higher weight, height, and body mass index compared to women. Statistically significant differences were observed between sex and height (p < 0.001). Significant differences were found between sexes in knee flexor and extensor strength at different isokinetic speeds (30°, 120°, and 180°/s), except for the maximum peak strength knee flexion at 180°/s in the right leg. In the ankle, the variables inversion, eversion, and work strength values at different isokinetic speeds and full RoM, by sex, were not significantly different, except for the right (p = 0.004) and the left (p = 0.035) ankle full RoM. The study found lower knee extensor strength in women, indicating the need to improve knee flexor/extensor strength in women to match that of men, as seen in other joints. The results can guide the development of preventive and therapeutic interventions for lower limb injuries in basketball players.
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Affiliation(s)
- Néstor Pérez Mallada
- San Juan de Dios Foundation, 28015 Madrid, Spain
- Health Sciences Department, San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28015 Madrid, Spain
- Institute for Research in Technology (IIT), ICAI School of Engineering, Comillas Pontifical University, 28015 Madrid, Spain
| | - María Jesús Martínez Beltrán
- San Juan de Dios Foundation, 28015 Madrid, Spain
- Health Sciences Department, San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28015 Madrid, Spain
| | - María Ana Saenz Nuño
- Institute for Research in Technology (IIT), ICAI School of Engineering, Comillas Pontifical University, 28015 Madrid, Spain
| | - Ana S F Ribeiro
- Nursing Department, Faculty of Nursing, Physical Therapy and Podiatry, Complutense University of Madrid, 28040 Madrid, Spain
| | | | | | - Ana María Echeverri Tabares
- San Juan de Dios Foundation, 28015 Madrid, Spain
- Health Sciences Department, San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28015 Madrid, Spain
| | - Andrés Paramio Santamaría
- San Juan de Dios Foundation, 28015 Madrid, Spain
- Health Sciences Department, San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28015 Madrid, Spain
| | - Hugo Lamas Sánchez
- San Juan de Dios Foundation, 28015 Madrid, Spain
- Health Sciences Department, San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28015 Madrid, Spain
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Watterworth MWB, Wakeely F, Fitzgerald SA, La Delfa NJ. The effect of handedness on upper extremity isometric strength symmetry. APPLIED ERGONOMICS 2024; 114:104133. [PMID: 37696053 DOI: 10.1016/j.apergo.2023.104133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/31/2023] [Accepted: 08/31/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Understanding upper extremity strength symmetry can have important implications for ergonomics assessment and design. Few studies have examined isometric joint strength symmetry of left-handed individuals, or examined how handedness can influence strength. As such, the purpose of this study was to investigate the influence of handedness on dominant/non-dominant (D/ND) strength ratio in several moment directions about the shoulder, elbow, wrist, and hand. It was hypothesized that the isometric strength symmetry of left-handed individuals would be significantly different from that of right-handed individuals. METHODS The study recruited 28 participants to perform a series of maximal voluntary isometric contractions (MVCs) with both arms for various efforts about the shoulder, elbow, and wrist, as well as handgrip for a total of 68 MVCs. Strength symmetry ratios were computed, and a two-way mixed-model ANOVA evaluated the effects of handedness and MVC test on strength symmetry. INTERPRETATION Significant differences in D/ND ratios between right and left-handed individuals were found for 11 of the 17 explored exertion directions. Left-handed individuals tended to possess greater strength in their non-dominant limb, while right-handed individuals tended to have greater strength in their dominant limb. Left- and right-handed individuals often significantly differed in D/ND ratio, suggesting that separate normative values should be created to account for handedness when considering return-to-work or strength-based ergonomics design criterion.
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Affiliation(s)
| | - Fahima Wakeely
- Faculty of Health Sciences (Kinesiology), Ontario Tech University, Oshawa, Ontario, Canada
| | - Sarah A Fitzgerald
- Faculty of Health Sciences (Kinesiology), Ontario Tech University, Oshawa, Ontario, Canada
| | - Nicholas J La Delfa
- Faculty of Health Sciences (Kinesiology), Ontario Tech University, Oshawa, Ontario, Canada.
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Feng W, Ma M, Gao H, Yuan W, Li R, Guo H, Gu C, Sun Z, Zhang Y, Zheng L. Association between handgrip strength asymmetry and cognitive function across ethnicity in rural China: a cross-sectional study. Front Aging Neurosci 2023; 15:1191197. [PMID: 37273648 PMCID: PMC10235480 DOI: 10.3389/fnagi.2023.1191197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/05/2023] [Indexed: 06/06/2023] Open
Abstract
Background Recently, the association between handgrip strength (HGS) asymmetry and cognition has been revealed, but evidences are still scarce. Particularly, the association between asymmetric HGS and cognitive performance in various cognitive domains is unclear and whether this association is stable across ethnic groups is unknown. Method The population was from a longitudinal study in rural areas of Fuxin, Liaoning, China. The Chinese version of Montreal Cognitive Assessment-Basic (MOCA-BC) was used to evaluate the cognitive function. The HGS ratio was calculated as maximal non-dominant HGS divided by maximal dominant HGS. HGS ratio <0.9 or >1.1 was classified as asymmetric dominant/non-dominant HGS, respectively. Generalized linear models were used to analyze the relationship between asymmetric HGS and cognitive function adjusted for HGS, handedness, wave, age, sex, education, ethnicity, smoking, drinking, physical labor level, BMI, hypertension, diabetes and dyslipidemia. Result A total of 2,969 participants ≥50 years were included in this study. Adjusted for HGS and other confunding variables, there was an inverted U-shaped association between HGS ratio and MoCA-BC scores (P non-linear = 0.004). The association between HGS ratio and MoCA-BC scores was inconsistent among ethnic groups (P interaction = 0.048). In Han, only asymmetric non-dominant HGS was associated with lower cognitive scores [β = -0.67, 95% confidence interval (CI): -1.26 ∼-0.08, P = 0.027]; in Mongolians, asymmetric dominant HGS(β = -0.60, 95% CI: -1.35 ∼ 0.15, P = 0.115) and asymmetric non-dominant HGS (β = -0.56, 95% CI: -1.42 ∼ 0.31, P = 0.206) were all associated with lower cognitive scores, although no statistical significance was found. Asymmetric non-dominant HGS and lower HGS, but not asymmetric dominant HGS were all independently associated with impairment of Delayed Recall (OR = 1.35, 95% CI: 1.05 ∼ 1.74; OR per 5 kg decrease = 1.10, 95% CI: 1.01 ∼ 1.21) and Fluency (OR = 1.43, 95% CI: 1.15 ∼ 1.78; OR per 5 kg decrease = 1.10, 95% CI: 1.02 ∼ 1.19). Both asymmetric dominant HGS (OR = 1.34, 95% CI: 1.07 ∼ 1.67) and lower HGS (OR per 5 kg decrease = 1.21, 95% CI: 1.10 ∼ 1.32) were associated with impairment of visuoperception. Conclusion HGS and HGS asymmetry were all independently related to lower global cognitive performance. The association between HGS asymmetry and cognitive function varies among ethnic groups.
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Affiliation(s)
- Wenjing Feng
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Mingfeng Ma
- Department of Cardiology, Fenyang Hospital of Shanxi Province, Fenyang, Shanxi, China
| | - Hanshu Gao
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Wei Yuan
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Ruixue Li
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Hui Guo
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Cuiying Gu
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yao Zhang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liqiang Zheng
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Abstract
Since the ability to train the horse to be ambidextrous is considered highly desirable, rider asymmetry is recognized as a negative trait. Acquired postural and functional asymmetry can originate from numerous anatomical regions, so it is difficult to suggest if any is developed due to riding. The aim of this study was therefore to assess symmetry of posture, strength and flexibility in a large population of riders and to determine whether typical traits exist due to riding. 127 right handed riders from the UK and USA were categorized according to years riding (in 20 year increments) and their competition level (using affiliated test levels). Leg length, grip strength and spinal posture were measured and recorded by a physiotherapist. Standing and sitting posture and trunk flexibility were measured with 3-D motion capture technology. Right-left differences were explored in relation to years riding and rider competitive experience. Significant anatomical asymmetry was found for the difference in standing acromion process height for a competition level (−0.07±1.50 cm Intro/Prelim; 0.02±1.31 cm Novice; 0.43±1.27 cm Elementary+; p=0.048) and for sitting iliac crest height for years riding (−0.23±1.36 cm Intro/Prelim; 0.01±1.50 cm Novice; 0.86±0.41 cm Elementary+; p=0.021). For functional asymmetry, a significant interaction was found for lateral bending ROM for years riding x competition level (p=0.047). The demands on dressage riders competing at higher levels may predispose these riders to a higher risk of developing asymmetry and potentially chronic back pain rather than improving their symmetry.
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