Handgrip strength predicts persistent walking recovery after hip fracture surgery.
BACKGROUND
In older people, hip fractures often lead to disability and death. We evaluated handgrip strength, an objective measure of physical function for bedridden patients, as a predictor of walking recovery in the year after fracture surgery.


METHODS
This multicenter prospective cohort study included 504 patients, aged 70 years or more, who were admitted to the hospital for hip fracture surgery and were formerly able to walk independently. A multidimensional geriatric evaluation that included a physical examination, Short Portable Mental Status Questionnaire, Geriatric Depression Scale, Charlson Index, Basic Activities of Daily Living, and grip strength was administered at the time of admission. Follow-ups were performed every 3 months for 1 year after surgery to assess functional status and survival. The walking recovery probability was evaluated using multivariable logistic regression models.


RESULTS
The mean age of the participants was 85.3 ± 5.5 years, and 76.1% of the participants were women. The mean grip strength was greater in men (β: 6.6 ± 0.62, P < .001) and was directly related to the Short Portable Mental Status Questionnaire results (P < .001), Basic Activities of Daily Living results (P < .001), serum vitamin D levels (P = .03), and time before surgery (P < .001), whereas it was inversely related to age (P < .001), Geriatric Depression Scale score (P < .001), and Charlson Index (P < .001). After adjusting for confounders, the grip strength was directly associated with the probability of both incident and persistent walking recovery (odds ratio highest tertile vs lowest tertile, 2.84, confidence interval, 1.76-4.59 and 2.79, confidence interval, 1.35-5.79, respectively).


CONCLUSIONS
In older patients with hip fractures, early grip strength evaluation might provide important prognostic information regarding the patient's future functional trajectory.
Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
Elisabetta
E
Savino
Emilio
E
Martini
Fulvio
F
Lauretani
Giulio
G
Pioli
Anna Maria
AM
Zagatti
Carlo
C
Frondini
Francesca
F
Pellicciotti
Antonio
A
Giordano
Alberto
A
Ferrari
Anna
A
Nardelli
Maria Luisa
ML
Davoli
Amedeo
A
Zurlo
Maria Lia
ML
Lunardelli
Stefano
S
Volpato
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D015331:Cohort Studies; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016896:Treatment Outcome; D016138:Walking
Grip strength; Hip fracture; Walking recovery