Across 17 studies of adults aged 50 and older (eight rated good quality, nine fair), higher grip strength was generally linked to lower odds of recurrent and injurious falls. Leg strength was assessed in just one study and leg power in two. Both power studies reported lower odds of injurious falls at higher power, similar in size to the grip associations, but only one reached statistical significance. Sex-specific patterns remain largely unexamined.
The grip finding fits a broader literature treating handgrip as a convenient proxy for overall muscle health, and it supports clinicians adding a dynamometer reading to fall-risk screening. Still, grip is probably a marker of general frailty more than a direct cause of falling. Balance, gait speed, and leg capacity are mechanistically closer to preventing a fall, and those are exactly the measures this review found underrepresented. Deliberately excluding chair-stand tests sharpened the focus on direct strength and power but also left out the performance tests most used in practice. The leg power signal is intriguing, since rapid force production is what arrests a stumble, but two studies cannot carry a conclusion. Observational designs, inconsistent injury definitions, and single-reviewer data extraction and bias rating add caution. Exercise trials show that progressive resistance and power training reduce falls, so this review mainly clarifies what to measure rather than what to do. Confirmatory on grip, and a clear call for better lower-limb data.