title: Handgrip strength of the elderly after hip fracture repair correlates with functional outcome.
abstract: OBJECTIVE
  To investigate the relationship between handgrip strength (HG) and upper limb functioning of hip fracture operated elderly patients and their functional outcome 6 months post-op.
  
  
  METHODS
  Retrospectively, data on 105 post-operative hip fracture patients was analyzed. Functional level was measured by the Functional Independence Measure (FIM) and HG by hand dynamometer, 7-10 days, 1, 3 and 6 months post-op. FIM1 up-to FIM4 (FIM1-FIM4) and HG1 up-to HG4 (HG1-HG4) were determined. Pre-fracture upper limb function was evaluated using the disabilities of the arm, shoulder and hand (DASH) questionnaire. The Mini-Mental-State Examination evaluated cognition.
  
  
  RESULTS
  FIM1-FIM4 scores increased during the 6-month follow-up; HG1-HG4 scores remained unchanged. No differences were found in FIM1-FIM4 and DASH scores between genders. HG1-HG4 scores were significantly higher in men (p = 0.04-0.005). FIM1-FIM4, HG1-HG4 and DASH scores were higher in the cognitively normal patients (p < 0.001). A fair correlation was found between all HG and FIM scores (R = 0.36-0.71, p < 0.001), and between DASH and FIM scores (R = 0.5-0.7, p < 0.001). Log HG1 and FIM4 scores were highly correlated (R(2) = 0.54, p < 0.001). Regression analysis found that only, and in the following order were Log HG1, FIM1, DASH and age significant factors affect FIM4 score (R(2) = 0.69).
  
  
  CONCLUSIONS
  HG and FIM scores, a week post-op., combined with upper limb functioning and age, can have a 69% prediction accuracy for motor functioning 6 months post-fracture. HG measurement, a week post-hip fracture repair, might be considered in estimating functional motor outcome, and eventually additional interventions should be employed to increase muscle strength and, thus, improve functional outcome.
authors.affiliation: Department of Geriatrics Surgery, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Petach Tikvah, Israel. beloy@clalit.org.il
authors.forename: Yichayaou
authors.initials: Y
authors.lastname: Beloosesky
authors.forename: Avraham
authors.initials: A
authors.lastname: Weiss
authors.forename: Maya
authors.initials: M
authors.lastname: Manasian
authors.forename: Moshe
authors.initials: M
authors.lastname: Salai
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D018737:Hand Strength; D006620:Hip Fractures / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D010809:Physical Fitness; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012189:Retrospective Studies