title: Association between functional capacity tests and fractures: an eight-year prospective population-based cohort study.
abstract: This study of postmenopausal women (n=2,928) with an eight-year follow-up revealed that impairment in functional status associated with the increased fracture risk. The standing-on-one-foot and grip strength tests and a question about self-assessed ability to move can be used to identify women with a high risk of suffering a fracture.
  
  
  BACKGROUND
  Poor functional status has pointed to associate with injurious falls and consequent fractures. Our aim was to define association between functional capacity and fractures.
  
  
  METHODS
  This study was based on the Osteoporosis Risk Factor and Prevention Study (OSTPRE). A total of 2,928 postmenopausal women took part in the functional capacity and muscle strength tests. The duration of fracture follow-up varied from 6.43 to 9.86 (mean 8.37) years and the first fracture was the end-point event for the statistical analyses. All analyses were done with Cox-regression.
  
  
  RESULTS
  A total of 261 end-point fractures occurred. In multivariate analysis the inability to stand-on-one-foot for 10 seconds increased the risk of hip fracture (hazard ratio with 95% CI) 9.11-fold (1.98-42.00). Decreased grip strength associated with 1.05-fold (1.01-1.09) increased risk of hip fractures. Low leg extension strength associated with 1.02-fold (1.00-1.03) higher risk for all fractures. The self-assessed ability to walk less than 100 meters at baseline increased the risk of ankle 2.36-fold (1.10-5.08), hip 11.57-fold (2.73-49.15) and clinical vertebral fractures 3.85-fold (1.45-10.22).
  
  
  CONCLUSIONS
  According to these results the standing-on-one-foot less than 10 seconds, grip strength and a question about ability to walk less than 100 meters may help to predict postmenopausal fractures.
authors.affiliation: Bone and Cartilage Research Unit, University of Kuopio, P.O. Box 1627, Mediteknia Building, 70211 Kuopio, Finland. Matti.Karkkainen@uku.fi
authors.forename: M
authors.initials: M
authors.lastname: Kärkkäinen
authors.forename: T
authors.initials: T
authors.lastname: Rikkonen
authors.forename: H
authors.initials: H
authors.lastname: Kröger
authors.forename: J
authors.initials: J
authors.lastname: Sirola
authors.forename: M
authors.initials: M
authors.lastname: Tuppurainen
authors.forename: K
authors.initials: K
authors.lastname: Salovaara
authors.forename: J
authors.initials: J
authors.lastname: Arokoski
authors.forename: J
authors.initials: J
authors.lastname: Jurvelin
authors.forename: R
authors.initials: R
authors.lastname: Honkanen
authors.forename: E
authors.initials: E
authors.lastname: Alhava
mesh_terms: D004812:Epidemiologic Methods; D005260:Female; D005387:Finland / Q000453:epidemiology; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology*; D018737:Hand Strength; D006801:Humans; D008875:Middle Aged; D053580:Muscle Strength; D017698:Postmenopause / Q000502:physiology; D004856:Postural Balance; D011379:Prognosis; D016138:Walking