Handgrip Strength Reference Values and Compositional Associations with Physical Activity in Early Childhood: A Large Sample Study of Swedish Preschoolers Ramírez Osuna, Ana Campos Garzón, Pablo Huertas Delgado, Francisco Javier Ahlqvist, Viktor H. Wilén, Charlotte Henriksson, Pontus Lundberg, Tommy R. Neovius, Martin Dahlén, Micael Berglind, Daniel Muscular strength Reference values Preschoolers A total of 3,218 preschool children (48.53% female) aged 3.0–5.5 years from Sweden were included. Handgrip strength was measured using a validated analog dynamometer following standardized procedures. Movement behaviours were assessed in a subsample of 2,328 children who had both handgrip data and valid accelerometer recordings. Compositional data analysis was used to examine associations between handgrip strength and the 24-hour time-use composition, adjusting for age, sex, body mass index, parental education, and wear time. Age- and sex-specific percentiles for handgrip strength were developed. Boys showed higher handgrip values than girls at all ages (e.g., median increased from 4.08 to 7.42 kg in boys and from 3.45 to 6.87 kg in girls between ages 3 and 5 years). When the proportion of time spent in MVPA increased relative to the other behaviours, handgrip strength rose by + 1.22 kg; the opposite was observed for ST, which related to − 0.84 kg lower handgrip strength. No significant associations were observed for LPA or sleep duration (LPA: β =-0.48 kg, 95% CI: -1.23, 0.27; sleep: β = 0.10 kg, 95% CI: -0.37, 0.57). 2026-03-10T13:25:28Z 2026-03-10T13:25:28Z 2026-02-27 journal article Ramírez-Osuna, A., Campos-Garzón, P., Huertas-Delgado, F.J. et al. Handgrip Strength Reference Values and Compositional Associations with Physical Activity in Early Childhood: A Large Sample Study of Swedish Preschoolers. Sports Med - Open 12, 19 (2026). https://doi.org/10.1186/s40798-026-00992-4 https://hdl.handle.net/10481/112022 10.1186/s40798-026-00992-4 eng http://creativecommons.org/licenses/by/4.0/ open access Atribución 4.0 Internacional Springer Nature