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Association between functional capacity tests and fractures: An eight-year prospective population-based cohort study

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Abstract

Summary

This study of postmenopausal women (n = 2,928) with an eight-year follow-up revealed that impairment in functional status associated with the increased fracture risk. The standing-on-one-foot and grip strength tests and a question about self-assessed ability to move can be used to identify women with a high risk of suffering a fracture.

Introduction

Poor functional status has pointed to associate with injurious falls and consequent fractures. Our aim was to define association between functional capacity and fractures.

Methods

This study was based on the Osteoporosis Risk Factor and Prevention Study (OSTPRE). A total of 2,928 postmenopausal women took part in the functional capacity and muscle strength tests. The duration of fracture follow-up varied from 6.43 to 9.86 (mean 8.37) years and the first fracture was the end-point event for the statistical analyses. All analyses were done with Cox-regression.

Results

A total of 261 end-point fractures occurred. In multivariate analysis the inability to stand-on-one-foot for 10 seconds increased the risk of hip fracture (hazard ratio with 95% CI) 9.11-fold (1.98–42.00). Decreased grip strength associated with 1.05-fold (1.01–1.09) increased risk of hip fractures. Low leg extension strength associated with 1.02-fold (1.00–1.03) higher risk for all fractures. The self-assessed ability to walk less than 100 meters at baseline increased the risk of ankle 2.36-fold (1.10–5.08), hip 11.57-fold (2.73–49.15) and clinical vertebral fractures 3.85-fold (1.45–10.22).

Conclusion

According to these results the standing-on-one-foot less than 10 seconds, grip strength and a question about ability to walk less than 100 meters may help to predict postmenopausal fractures.

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Acknowledgements

We thank Mr. Vesa Kiviniemi for statistical advice, Ms. Seija Oinonen for technical support and Mr. Ewen Macdonald for linguistic form check. This study was supported by the Academy of Finland grant 113999, EVO grant of the Kuopio University Hospital and the Sigrid Juselius Foundation.

Conflicts of interest

None.

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Authors and Affiliations

  1. Bone and Cartilage Research Unit, University of Kuopio, P.O. Box 1627, Mediteknia Building, 70211, Kuopio, Finland

    M. Kärkkäinen, T. Rikkonen, H. Kröger, J. Sirola, M. Tuppurainen, K. Salovaara & R. Honkanen

  2. Department of Orthopaedics, Traumatology and Handsurgery, Kuopio University Hospital, Kuopio, Finland

    H. Kröger, J. Sirola & K. Salovaara

  3. Department of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland

    M. Tuppurainen

  4. Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland

    J. Arokoski

  5. Department of Physics, University of Kuopio and Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland

    J. Jurvelin

  6. Institute of Clinical Medicine, Department of Surgery, University of Kuopio, Kuopio, Finland

    E. Alhava

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  1. M. Kärkkäinen
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  2. T. Rikkonen
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Correspondence to M. Kärkkäinen.

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Kärkkäinen, M., Rikkonen, T., Kröger, H. et al. Association between functional capacity tests and fractures: An eight-year prospective population-based cohort study. Osteoporos Int 19, 1203–1210 (2008). https://doi.org/10.1007/s00198-008-0561-y

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  • DOI: https://doi.org/10.1007/s00198-008-0561-y

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