Evaluation of Physical Performance Level as a Fall Risk Factor in Women with a Distal Radial Fracture

Cho, Young Jae; Gong, Hyun Sik; Song, Cheol Ho; Lee, Young Ho; Baek, Goo Hyun

doi:10.2106/jbjs.l.01359

Cited by 29 publications

(36 citation statements)

References 37 publications

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“…Although the overall summary score showed no differences, some individual components such as the chair stand test and contralateral grip strength demonstrated decreased physical performance in the fracture cohort 8 . Although functional performance tests such as those used by Cho et al 8 can be criticized as lacking sensitivity 11 , the detection of these intrinsic differences reveals a need for a more refined investigation of the physical risk factors using more sensitive quantitative methods such as computerized balance platforms 7 .…”

Section: Discussionmentioning

confidence: 73%

“…Our data build upon the evaluation of physical performance by Cho et al 8 as a risk factor for distal radial fractures using the Short Physical Performance Battery, grip strength, and time spent walking daily in matched cohorts. Although the overall summary score showed no differences, some individual components such as the chair stand test and contralateral grip strength demonstrated decreased physical performance in the fracture cohort 8 .…”

Section: Discussionmentioning

confidence: 98%

“…However, describing those patients as being at risk for distal radial fractures is not as intuitive 6,7 . Some functional measures of physical performance, such as the Timed Up and Go test and contralateral grip strength, are decreased in patients who have sustained a distal radial fracture 3,8,9 . Nevertheless, factors generally associated with frailty, such as difficulty performing physical tasks, slower walking speed, and inactive lifestyle, may actually be protective for distal radial fractures because of reduced exposure to potential Disclosure: One author of this study (L.B.W.)…”

mentioning

confidence: 99%

“…falls 3,4,6,10 . Thus, the patients most at risk for distal radial fractures may be those who have had a subtle decline of physical performance and postural control but are not yet debilitated enough to have a decrease in activity level 8 . Providing evidence that physical decline increases risk of distal radial fractures in older individuals has proven to be challenging 3,4,6 .…”

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confidence: 99%

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Postural Stability in Older Adults with a Distal Radial Fracture

Louer

Boone

Guthrie

et al. 2016

The Journal of Bone and Joint Surgery

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Background: The physical risk factors leading to distal radial fractures are poorly understood. The goal of this study was to compare postural stability between older adults with and without a prior distal radial fragility fracture. Methods: This case-control evaluation was performed at a single tertiary institution. The fracture cohort comprised 23 patients treated for a low-energy distal radial fracture within 6 to 24 months prior to this study. Twenty-three age and sex-matched control participants, without a prior fragility fracture, were selected from an outpatient clinic population. All participants completed a balance assessment with a computerized balance platform device. Dynamic motion analysis (DMA) scores ranging from 0 to 1,440 points are produced, with lower scores indicating better postural stability. Participants also completed validated questionnaires for general health quality (EuroQol-5D-3L [EQ-5D-3L]) and physical activity (Physical Activity Scale for the Elderly [PASE]) and comprehensive health and demographic information including treatment for compromised balance or osteoporosis. Statistical analysis compared data between cases and controls using either the Student t test or the Mann-Whitney U test. Results: There were no significant differences (p > 0.05) in age, sex, body mass index, physical activity score, or EQ-5D-3L general health visual analog scale score between participants with or without prior distal radial fracture. The fracture cohort demonstrated poorer balance, with higher DMA scores at 933 points compared with 790 points for the control cohort (p = 0.008). Nineteen patients (83%) in the fracture cohort reported having dual x-ray absorptiometry (DXA) scans within 5 years prior to this study, but only 2 patients (9%) had ever been referred for balance training with physical therapy. Conclusions: Older adults who sustain low-energy distal radial fractures demonstrate impaired postural stability compared with individuals of a similar age who have not sustained such fractures. Following a distal radial fracture, these patients may benefit from interventions to improve postural stability. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Postural Stability in Older Adults with a Distal Radial Fracture

Louer

Boone

Guthrie

et al. 2016

The Journal of Bone and Joint Surgery

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“…However, BMD does not always accurately reflect fracture risk and up to 50 % of those who sustain fragility fractures do not have osteoporosis based on BMD testing [3]. In particular, BMD is not consistently lower than normal controls in patients with a distal radius fracture (DRF) [4][5][6], suggesting that factors other than BMD, such as bone microarchitecture, bone geometry, micro-damage, mineralization, bone turnover, and propensity to fall, influence bone strength and fracture risk [7][8][9]. However, these structural properties of bone cannot be evaluated by using DXA [10].…”

Section: Introductionmentioning

confidence: 99%