Lower-limb pain, disease and injury burden as determinants of muscle strength deficit after hip fracture
Portegijs, E., Rantanen, T., Kallinen, M., Heinonen, A., Alén, M., Kiviranta, I., & Sipilä, S. (2009). Lower-limb pain, disease and injury burden as determinants of muscle strength deficit after hip fracture. The Journal of Bone and Joint Surgery, 91, 1720-1728. https://doi.org/10.2106/jbjs.g.01675
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The Journal of Bone and Joint SurgeryAuthors
Date
2009Discipline
Gerontologia ja kansanterveysGerontologian tutkimuskeskusHyvinvoinnin tutkimuksen yhteisöGerontology and Public HealthGerontology Research CenterSchool of WellbeingCopyright
© 2009 by the The Journal of Bone and Joint Surgery, Inc. Published in this repository with the kind permission of the publisher.
Background: Hip fracture may result in an asymmetrical lower-limb strength deficit. The
deficit may be related to the trauma, surgical treatment, pain, or disuse of the fractured limb.
However, disease and injury burden or musculoskeletal pain in the other limb may reduce
muscle strength on that side, reducing the asymmetrical deficit. Our study aim was to explore
the asymmetrical strength deficit and to determine potential underlying factors in persons 6
months to 7 years after a hip fracture.
Methods: Asymmetrical deficit was calculated ((fractured/sum both lower-limbs) x 100%)
for isometric knee extension torque, rate of force development during isometric testing, and
leg extension power. The asymmetrical measure for lower-limb muscle mass was calculated
(fractured-non-fractured), and that of lower-limb pain and disease and injury burden (nonfractured-fractured).
Results: Half of the participants had no consistent asymmetrical deficit on the fractured side.
Regression analyses showed that asymmetrical measures of lower-limb pain, muscle mass
and disease and injury burden predicted asymmetrical deficit in knee extension torque
(R2
=0.43) and rate of force development (R2
=0.36). More intense pain and disease and injury
burden affecting the non-fractured limb and smaller muscle mass relative to the fractured
limb were associated with a smaller asymmetrical deficit.
Conclusions: Following hip fracture, preventing decreases in muscle strength and power and
a large asymmetrical deficit by targeted pain management and rehabilitation may help to
reduce the risk of subsequent mobility limitations and falls.
...


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