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a Epidemiology, Demography and Biometry Program, National Institute on Aging, Bethesda, Maryland
b Institute for Research in Extramural Medicine, Faculty of Medicine, Vrije University, Amsterdam, The Netherlands
c ManagedEDGE, Euro RSCG, New York, New York
d Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore
Marjolein Visser, Institute for Research in Extramural Medicine, Faculty of Medicine, Vrije University, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands E-mail: m.visser.emgo{at}med.vu.nl.
William B. Ershler, MD
Background. Hip fracture in elderly persons has a serious impact on long-term physical function. This study determines the change in muscle strength and muscle mass after a hip fracture, and the associations between these changes and mobility recovery.
Methods. Ninety community-dwelling women aged 65 years and older who had recently experienced a fracture of the proximal femur were included in the study. At 2 to 10 days after hospital admission, the women's grip strength, ankle dorsiflexion strength, and regional muscle mass (by dual-energy x-ray absorptiometry) were measured, and the prefracture level of independence for five mobility function items was assessed. All measurements were repeated at 12 months.
Results. At follow-up, only 17.8% of the women had returned to their prefracture level of mobility function for all five items. Mobility function recovery was not related to change in skeletal muscle mass of the nonfractured leg or the arms. However, women who lost grip strength (mean loss of -28.7%, SD = 16.9%), or who lost ankle strength of the nonfractured leg (mean loss of -21.5%, SD = 14.7%), had a worse mobility recovery compared with those who gained strength ( p = .04 and p = .09, respectively). In addition, chronic disease ( p = .03), days hospitalized ( p = .04), and self-reported hip pain ( p = .07) were independent predictors of decline in mobility function.
Conclusions. The results suggest that loss of muscle strength, but not loss of muscle mass, is an independent predictor of poorer mobility recovery 12 months after a hip fracture. When confirmed by other studies, these findings may have implications for rehabilitation strategies after a hip fracture.
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