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Background: Abnormal hand grip strength has been associated with increased mortality and depressive/anxiety disorders. This study's aim is to determine a relationship between hand grip strength, weight loss, BMI, comorbidities, and depression, anxiety, and stress in a bariatric surgery population.
Methods and Procedures: Demographic, preop, and 3 month postop data were prospectively collected on 35 consecutive laparoscopic surgeries (18 roux-en-Y-gastric bypass, 15 sleeve gastrectomy, and 2 adjustable gastric band) at a single academic institution. At each clinic visit, patients enrolled in the study participated in a hand grip strength test using a hand dynamometer. Participants also filled out a Depression, Anxiety, Stress Scales (DASS) Survey preoperatively and 3 months postop. Demographic, weight loss, absolute hand grip strength, and hand grip as a percentage of established norms were compared to DASS scores by student t-tests and regression analyses using GraphPad Prism6 software.
Results: At 3 months postop, 74.3% of patients completed hand grip and survey tests. Patient demographics included an average BMI 46.1, age 43.7, 52.6% white, and 3.9 total preoperative comorbidities. Major pre-op comorbidities included hypertension 55.3%, diabetes 39.5%, hyperlipidemia 44.7%, sleep apnea 47.4%, and depression 26.3%. Average operative time was 134.2 minutes. Hand grip strength was maintained at 3 months postop despite massive weight loss. No correlation was found between preoperative hand grip strength and percent excess weight loss at 3 months (r2 = 0.0014; p = 0.42). Participants with hand grip strength below normal had lower operative times (111.2 ±35.9) than those with hand grip strength above normal (154.8 ±43.3; p <0.01). Moreover, a positive correlation was observed between adjusted preoperative hand grip strength and operative time, with greater adjusted hand grip strength correlating with longer operative time (r2 = 0.193; p < 0.01). BMI alone, however, was not correlated with operative time (r2 = 0.0262; p = 0.16). A relationship was observed between preop hand grip strength and preoperative total DASS score, with weaker hand grip correlating to higher (worse) DASS scores (p <0.01). Furthermore, greater improvements in hand grip strength 3 months postop correlated with greater improvements in DASS score (p <0.01).
Conclusions: Hand grip had a positive relationship with operative time independent of BMI. Greater hand grip strength was correlated with lower DASS scores preoperatively and at 3 months postoperatively. Improvements in hand grip strength were correlated with improvements in DASS scores suggesting that bariatric surgery patients' hand grip strength might be a marker for their psychological strength. Further investigation will reveal associations between hand grip and longer-term weight loss and comorbidity improvement.