title: Balance confidence and functional balance are associated with physical disability after hip fracture.
abstract: BACKGROUND
  This cross-sectional study investigated the associations between balance confidence, functional balance, and physical disability among older people after hip fracture.
  
  
  METHODS
  The study utilizes baseline data of two randomized controlled trials (ISRCTN34271567 and ISRCTN53680197). The participants were 159 community-dwelling over 60-year-old people. Health, fracture status, the date and type of surgery, and contraindications for participation were assessed in a clinical examination. Balance confidence was assessed by the Activities-specific Balance Confidence Scale (ABC) and functional balance by the Berg Balance Scale. Physical disability was assessed by a questionnaire containing 14 questions on perceived difficulty in basic (ADL) and instrumental activities of daily living (IADL). Two sum scores were composed: ADL score (range 0-6) and IADL score (range 0-8). Isometric knee extension force was measured using a dynamometer. Pain and use of walking aids were assessed by a questionnaire. The negative binomial regression analysis was used to analyze the associations.
  
  
  RESULTS
  A higher ABC score was associated with a lower risk for ADL (IRR 0.99; 95% CI 0.98-0.99) and IADL disability (0.99; 0.98-0.99) in the fully adjusted models. Also a higher BBS score was associated with a lower risk for ADL (0.98; 0.96-0.99) and IADL disability (0.98; 0.97-0.99) in the fully adjusted models.
  
  
  CONCLUSIONS
  Decreased balance confidence and impaired functional balance are associated with physical disability in older people after hip fracture.
authors.affiliation: Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland. johanna.edgren@jyu.fi
authors.forename: Johanna
authors.initials: J
authors.lastname: Edgren
authors.forename: Anu
authors.initials: A
authors.lastname: Salpakoski
authors.forename: Taina
authors.initials: T
authors.lastname: Rantanen
authors.forename: Ari
authors.initials: A
authors.lastname: Heinonen
authors.forename: Mauri
authors.initials: M
authors.lastname: Kallinen
authors.forename: Mikaela B
authors.initials: MB
authors.lastname: von Bonsdorff
authors.forename: Erja
authors.initials: E
authors.lastname: Portegijs
authors.forename: Sanna
authors.initials: S
authors.lastname: Sihvonen
authors.forename: Sarianna
authors.initials: S
authors.lastname: Sipilä
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006620:Hip Fractures / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D010147:Pain Measurement; D004856:Postural Balance / Q000502:physiology*; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D011795:Surveys and Questionnaires