Handgrip strength but not appendicular lean mass is an independent predictor of functional outcome in hip-fracture women: a short-term prospective study.
OBJECTIVE
To investigate the contribution of muscle mass and handgrip strength in predicting the functional outcome after hip fracture in women.


METHODS
Observational study.


METHODS
Rehabilitation hospital.


METHODS
White women (N=123 of 149) who were consecutively admitted to a rehabilitation hospital because of their first fracture of the hip.


METHODS
Not applicable.


METHODS
We measured appendicular lean mass (aLM) by dual-energy x-ray absorptiometry (DXA) 21.1 ± 8.7 (mean ± SD) days after hip fracture occurrence in the 123 women. On the same day, we assessed grip strength at the nondominant arm with a dynamometer. At the end of acute inpatient rehabilitation we measured the ability to function in activities of daily living by using the Barthel Index, and lower limb performance by using the Timed Up and Go (TUG) test.


RESULTS
We found significant correlations between handgrip strength measured before rehabilitation and Barthel Index scores after rehabilitation (ρ=.50; P<.001), Barthel Index effectiveness (ρ=.45; P<.001), and the TUG test (ρ=-.41; P<.001). Conversely, we found no significant correlations between aLM/height(2) and Barthel Index scores after rehabilitation (ρ=.075; P=.41), Barthel Index effectiveness (ρ=.06; P=.53), or the TUG test (ρ=.005; P=.96). Significant associations between grip strength and all the outcome measures persisted after adjustment for 8 potential confounders, including Barthel Index scores before rehabilitation, age, number of medications, number of comorbidities, pressure ulcers, concomitant infections, time between fracture occurrence and assessment, and aLM/height(2).


CONCLUSIONS
Grip strength, but not DXA-assessed aLM, significantly predicted short-term functional outcome in women after a hip fracture.
Osteoporosis Research Center, Division of Physical Medicine and Rehabilitation, Presidio Sanitario San Camillo, Torino, Italy. Electronic address: marco.di.monaco@alice.it.
Marco
M
Di Monaco
Osteoporosis Research Center, Division of Physical Medicine and Rehabilitation, Presidio Sanitario San Camillo, Torino, Italy.
Carlotta
C
Castiglioni
Service of Occupational Therapy, Presidio Sanitario San Camillo, Torino, Italy.
Elena
E
De Toma
Service of Occupational Therapy, Presidio Sanitario San Camillo, Torino, Italy.
Luisa
L
Gardin
Service of Occupational Therapy, Presidio Sanitario San Camillo, Torino, Italy.
Silvia
S
Giordano
Department of Social Science, University of Turin, Torino, Italy.
Roberto
R
Di Monaco
Osteoporosis Research Center, Division of Physical Medicine and Rehabilitation, Presidio Sanitario San Camillo, Torino, Italy.
Rosa
R
Tappero
D000368:Aged; D001823:Body Composition; D004185:Disability Evaluation; D005260:Female; D018737:Hand Strength; D006620:Hip Fractures / Q000503:physiopathology* / Q000534:rehabilitation*; D006801:Humans; D018482:Muscle, Skeletal / Q000503:physiopathology*; D026741:Physical Therapy Modalities; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020127:Recovery of Function; D016896:Treatment Outcome
Body composition; DXA scan; Hand strength; Hip fractures; Rehabilitation; Skeletal muscle