Handgrip strength effectiveness and optimal measurement timing for predicting functional outcomes of a geriatric hip fracture

Abstract

Handgrip strength (HGS) now draws attention as one of the predictors of outcomes following geriatric hip fracture; however, its effectiveness and the optimal time to assess HGS remain unknown. Herein, we aimed to determine the usefulness of HGS in predicting the outcomes of geriatric hip fracture and to find the most effective time to measure HGS in both the low muscle strength and normal hip fracture groups. The study was performed prospectively for 79 geriatric hip fracture patients. HGS was measured during the admission period and the one-week postoperative period. Walking ability and quality of life were assessed using Koval scores and the European Quality of Life Five Dimension (EQ-5D) scale at the admission period and postoperatively at 3, 6, and 12 months, respectively. The relationship between pre/postoperative HGS and functional outcomes was assessed, and the functional score between the “low muscle strength” and “normal muscle strength” groups was compared. The association between HGS asymmetry and low strength with functional limitations was determined. For the preoperative HGS, the Koval score showed a significant relationship in the postoperative 6-month (r = −0.295, P = 0.008) and 12-month (r = −0.266, P = 0.019) periods; also, the EQ-5D score showed a significant relationship in the postoperative 6-month and 12-month periods (r = 0.344, P < 0.001, and r = 0.386, P = 0.001, respectively). For the postoperative HGS, the Koval score showed a significant relationship in the 6-month (r = −0.432, P < 0.001) and 12-month (r = −0.344, P = 0.002) postoperative periods. Also, the EQ-5D score showed a significant relationship in the 3-month (r = 0.340, P = 0.010), 6-month (r = 0.476, P < 0.001), and 12-month (r = 0.471, P < 0.001) postoperative periods. The incidence of preoperative and postoperative low HGS was 78.5% and 70.9%, respectively. The “low-strength” group had poor Koval scores and EQ-5D at postoperative month 12 and poor functional outcomes earlier in the follow-up (postoperative 6- and 12-month Koval scores and postoperative 3-, 6-, and 12-month EQ-5D), respectively (P = 0.008 and P = 0.003; P = 0.003, P = 0.001, and P = 0.001). The effect of HGS asymmetry and low strength on functional limitations remained undetermined. Both preoperative and postoperative HGS reflected functional outcomes of patients with hip fracture during the 12-month follow-up. Postoperative HGS had a higher prognostic value than preoperative HGS.

Association of Handgrip Strength with Hip Fracture and Falls in Community‐dwelling Middle‐aged and Older Adults: A 4‐Year Longitudinal Study

“…Han et al . found that pre‐ and post‐operative HGS was associated with walking ability and quality of life after hip fracture 20 . Selakovic et al .…”

The Surgical Timing and Prognoses of Elderly Patients with Hip Fractures: A Retrospective Analysis

“…Moreover, there were no significant differences in the intraoperative blood loss and surgical duration between the two groups, indicating that surgical timing would not affect the surgical course.The results are consistent with previous studies. 32 , 33 …”

One-year change in handgrip strength in patients with hip fracture: a prospective comparison with hip disease

“…Handgrip strength (HGS) has been adopted as one of the diagnostic tools for sarcopenia and is gaining attention because of its relationship with osteoporotic hip fractures. Additionally, it has been highlighted as an easy and efficient modality for predicting the prognosis and degree of functional recovery after hip fractures [ 3 – 5 ].…”

“…Recently, Han et al reported that pre- and postoperative HGS reflected functional outcomes following hip fracture. They favored the postoperative HGS compared to preoperative HGS due to the higher prognostic value [ 5 ]. Although some authors have reported a relationship between lower HGS and hip fracture risk or lower functional recovery after surgery [ 6 , 8 , 9 ], there have also been contradicting results refuting the value of HGS in predicting hip fracture outcomes [ 12 ].…”