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Vol. 22. Issue 5.
Pages 355-369 (01 September 2018)
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Vol. 22. Issue 5.
Pages 355-369 (01 September 2018)
Systematic Review
DOI: 10.1016/j.bjpt.2018.02.006
Reference values for muscle strength: a systematic review with a descriptive meta-analysis
Poliana do Amaral Benfica, Larissa Tavares Aguiar, Sherindan Ayessa Ferreira de Brito, Luane Helena Nunes Bernardino, Luci Fuscaldi Teixeira-Salmela, Christina Danielli Coelho de Morais Faria
Corresponding author

Corresponding author at: Departamento de Fisioterapia, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627 – Campus Pampulha, CEP: 31270-910, Belo Horizonte, Minas Gerais, Brazil.
Universidade Federal de Minas Gerais (UFMG), Departamento de Fisioterapia, Belo Horizonte, Minas Gerais, Brazil

  • Most of the studies included in this review showed adequate methodological quality.

  • There is information only on the reference values for muscle strength measured with dynamometers/myometers.

  • The meta-analysis provided reference values for the strength of 14 muscle groups.

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Tables (4)
Table 1. Methodological quality of the included studies, according to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) (n=45).
Table 2. Characteristics of the studies that established the reference values for isometric strength of the upper/lower limb and axial muscular groups.
Table 3. Characteristics of the studies that established the reference values for isokinetic strength.
Table 4. Meta-analysis results: Reference values (means±SD) and coefficients of variation (%) of the strength measures, in Newton or Pounds, that resulted from the combination of the values of the studies with similar characteristics.
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Muscle strength is an important component of health.


To describe and evaluate the studies which have established the reference values for muscle strength on healthy individuals and to synthesize these values with a descriptive meta-analysis approach.


A systematic review was performed in MEDLINE, LILACS, and SciELO databases. Studies that investigated the reference values for muscle strength of two or more appendicular/axial muscle groups of health individuals were included. Methodological quality, including risk of bias was assessed by the QUADAS-2. Data extracted included: country of the study, sample size, population characteristics, equipment/method used, and muscle groups evaluated.


Of the 414 studies identified, 46 were included. Most of the studies had adequate methodological quality. Included studies evaluated: appendicular (80.4%) and axial (36.9%) muscles; adults (78.3%), elderly (58.7%), adolescents (43.5%), children (23.9%); isometric (91.3%) and isokinetic (17.4%) strength. Six studies (13%) with similar procedures were synthesized with meta-analysis. Generally, the coefficient of variation values that resulted from the meta-analysis ranged from 20.1% to 30% and were similar to those reported by the original studies. The meta-analysis synthesized the reference values of isometric strength of 14 muscle groups of the dominant/non-dominant sides of the upper/lower limbs of adults/elderly from developed countries, using dynamometers/myometer.


Most of the included studies had adequate methodological quality. The meta-analysis provided reference values for the isometric strength of 14 appendicular muscle groups of the dominant/non-dominant sides, measured with dynamometers/myometers, of men/women, of adults/elderly. These data may be used to interpret the results of the evaluations and establish appropriate treatment goals.

Reference values
Muscle strength
Upper extremity
Lower extremity


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