Differences in musculoskeletal health due to gender in a rural multiethnic cohort: a Project FRONTIER study.
BACKGROUND
Very few studies have investigated differences in musculoskeletal health due to gender in a large rural population. The aim of this study is to investigate factors affecting musculoskeletal health in terms of hand grip strength, musculoskeletal discomfort, and gait disturbance in a rural-dwelling, multi-ethnic cohort.


METHODS
Data for 1117 participants (40 years and older, 70% female) of an ongoing rural healthcare study, Project FRONTIER, were analyzed. Subjects with a history of neurological disease, stroke and movement disorder were excluded. Dominant hand grip strength was assessed by dynamometry. Gait disturbance including stiff, spastic, narrow-based, wide-based, unstable or shuffling gait was rated. Musculoskeletal discomfort was assessed by self-reported survey. Data were analyzed by linear, logistic regression and negative binomial regressions as appropriate. Demographic and socioeconomic factors were adjusted in the multiple variable analyses.


RESULTS
In both genders, advanced age was a risk factor for weaker hand grip strength; arthritis was positively associated with musculoskeletal discomfort, and fair or poor health was significantly associated with increased risk of gait disturbance. Greater waist circumference was associated with greater musculoskeletal discomfort in males only. In females, advanced age is the risk factor for musculoskeletal discomfort as well as gait disturbance. Females with fair or poor health had weaker hand grip strength. Higher C-reactive protein and HbA1c levels were also positively associated with gait disturbance in females, but not in males.


CONCLUSIONS
This cross-sectional study demonstrates how gender affects hand grip strength, musculoskeletal discomfort, and gait in a rural-dwelling multi-ethnic cohort. Our results suggest that musculoskeletal health may need to be assessed differently between males and females.
Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA.
J M
JM
Brismée
Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA.
S
S
Yang
F. Marie Hall Institute for Rural and Community Health Research, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA.
M E
ME
Lambert
Graduate Healthcare Engineering, Whitacre College of Engineering, Texas Tech University, Lubbock, TX, 79409, USA.
M C
MC
Chyu
Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA.
P
P
Tsai
Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA.
Y
Y
Zhang
Department of Nutrition and Food Hygiene, Xinjiang Medical University, Xinjiang, China.
J
J
Han
F. Marie Hall Institute for Rural and Community Health Research, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA.
C
C
Hudson
Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, USA.
Eunhee
E
Chung
Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA. leslie.shen@ttuhsc.edu.
C L
CL
Shen
D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006306:Health Surveys / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000453:epidemiology; D012424:Rural Population; D012727:Sex Characteristics
FRONTIER project; Gait; Gender; Hand grip strength; Musculoskeletal discomfort; Rural health