Physical fitness indicators such as hand grip strength (HGS) and flexibility, are essential markers of children's growth and functional development. This study aimed to establish culturally relevant normative reference values for hand grip strength (HGS) and the sit-and-reach test (SRT) among school-aged children (6-12 years) in Dhulikhel, Nepal, and to examine the associations of these measures with age, Gender and body mass index (BMI). Methods: A cross-sectional study was conducted among 359 (52.4% male, 47.6% female) typically developing school children aged 6 to 12 years in Dhulikhel. A TKK (Takei Hand Grip Dynamometer Model T.K.K. 5401) dynamometer was used to measure handgrip strength, and a specially constructed box was used for the sit-and-reach test. Data were analyzed using descriptive statistics with the Statistical Package for Social Sciences, version 26. Hand grip strength differed significantly by age and sex, with males demonstrating higher mean right (12.11 kg) and left (11.33 kg) handgrip strength than females. Age-stratified analysis revealed a progressive increase in handgrip strength with age in both hands (p < 0.01). Likewise, flexibility showed no significant gender (p = 0.61) or age-related differences (p = 0.10). BMI correlated moderately with handgrip strength (right: r = 0.485; left: r = 0.494) but weakly with flexibility (Spearman's rho = 0.037). This study provides culturally relevant normative reference values for handgrip strength and flexibility in school-aged children and its association with age, gender and BMI.
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