Pain and fractures are independently related to lower walking speed and grip strength: results from the population study "Good Ageing in Skåne".
BACKGROUND
Earlier reports on reduced physical performance and osteoporosis-related fractures have mostly been short-term studies. The aim of this investigation was to examine the effects of fractures on physical functioning 3 years after trauma, the latter being stratified for pain.


METHODS
The study consisted of a population-based case-control study including 289 subjects from the "Good Ageing in Skåne" project. Men and women with fractures, aged 60-93 years, were divided into one group with pain (FP, n = 71) and one without pain (FnP, n = 53). Fractures included vertebrae, hip, pelvis or ankle according to the national medical register. A third group of subjects without fractures or pain (CnP, n = 165) was used as control. Pain during the previous month, health variables, lifestyle, medication, use of a walking aid, and sociodemographic variables were self-reported. Walking 15 m, 2 x 15 m, and timed get-up-and-go (TUG)--all at self-selected and maximum speed--and maximum handgrip strength were assessed objectively.


RESULTS
Among the FP patients, almost half of the group suffered pain on a daily basis. The subjects in the CnP and FnP groups performed significantly better than the FP patient group in all functional tests. Median time for walking a distance of 15 m at self-selected speed was 16, 13 and 12 sec for the CnP, FnP and FP groups, respectively. Both fracture and pain independently explained lower walking speed (self-selected and maximum) as well as TUG, adjusted for age, sex and co-morbidity in a multiple regression model. Those who had sustained fractures more than 3 years previously performed significantly better in walking 15 m and 2 x 15 m at both self-elected and maximum speed than those with a more recent fracture, irrespective of pain.


CONCLUSIONS
After 3 years, patients who had sustained a fracture but who experienced no pain performed almost as well as control subjects. Pain and fracture were independently influenced by physical function.
Ekström
Henrik
H
Department of Health Sciences, Division of Geriatric Medicine, Lund University and Malmö University Hospital, Malmö, Sweden. henrik.ekstrom@med.lu.se
Elmståhl
Sölve
S
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D016022:Case-Control Studies; D005260:Female; D050723:Fractures, Bone / Q000209:etiology / Q000503:physiopathology*; D005598:Fractures, Spontaneous / Q000209:etiology / Q000503:physiopathology*; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications; D010146:Pain / Q000503:physiopathology*; D059408:Pain Management; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016138:Walking / Q000502:physiology*