Can early assessment of hand grip strength in older hip fracture patients predict functional outcome?

Abstract

Decreased muscle strength is not only a risk factor for hip fracture in older patients, but plays a role in recovery of physical function. Our aim was to assess the role of grip strength measured early after hip fracture, and classified according to the EWGSOP2 criteria in predicting short- and long-term functional recovery. One hundred ninety-one patients with acute hip fracture consecutively admitted to an orthopaedic hospital have been selected. A multidimensional geriatric assessment evaluating sociodemographic variables, cognitive status, functional status and quality of life prior to fracture, as well as perioperative variables were performed. Follow-ups at 3 and 6 months after surgery were carried out to evaluate functional recovery. Multivariate regression models were used to assess the predictive role of handgrip strength. The mean age of the participants was 80.3 ±6.8 years. Thirty-five percent of our patients with clinically relevant hand grip strength weakness were significantly older, more often female, had a lower BMI, and were of worse physical health. They also had a lower cognitive level, lower Barthel index, and lower EQ5D scores before fracture. Multivariate regression analysis adjusted for age and gender revealed that hand grip weakness was an independent predictor of worse functional outcome at 3 and 6 months after hip fracture for both genders and in all age populations. Our study supports the prognostic role of hand grip strength assessed at hospital admission in patients with hip fracture. Thus, clinicians should be encouraged to include hand grip assessment in their evaluation of hip fracture patients in the acute setting in order to optimize treatment of high-risk individuals.

Low Grip Strength As a Predictor of Recovery From Total Hip Arthroplasty (THA)

“…Our study further corroborated previous ndings [16,[18][19][20] about the patient characteristics associated with low GS in this population undergoing primary THA. As expected, there were signi cant differences in preoperative characteristics between the low GS and normal GS cohorts.…”

“…A number of previous studies have examined the predictive role of low GS for the clinical outcomes following orthopedic surgery [15][16][17][18][19]. For instance, Shen et al reported patients with high preoperative GS…”

“…to display a better surgical outcome in terms of disability and health status six months after spine surgery [15]. Selakovic et al showed multivariate regression analysis adjusted for age and gender revealed that grip weakness was an independent predictor of worse functional outcome at 3 and 6 months after hip fracture for both genders and in all age populations [16]. Similarly, Hershkovitz et al suggested that grip strength is independently associated with rehabilitation outcome in post-acute frail hip fracture patients [17].…”

“…Measuring GS after THA in a seated position would de nitely be a more standardized way to assess muscle strength. However, we have standardized the way to measure GS in all the included patients, and this approach was also used by other authors [16,24,25]. Consequently, it is reasonable to assume that measuring GS in the supine position is an appropriate way to assess function.…”

<p>Comparison of a Novel Muscle Training Device with Conventional Rehabilitation Training in Motor Dysfunction of Lower Limb Patients: A Pilot Study</p>

“…Therefore, it is of great significance to provide early rehabilitation training for patients with lower limb dyspraxia. 3,4 Several studies have reported a limited number of factors, such as pain, anxiety and low life quality that are caused by surgery associated with functional recovery. 5,6 Elderly patients are often accompanied by hypertension, osteoporosis and other health problems, which lead to slow wound healing following surgery.…”