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Physical activity in young hip fracture patients is associated with health-related quality of life and strength; results from a multicenter study

Lindestrand, Anna Gaki ; Rönnquist, Sebastian Strøm LU orcid ; Viberg, Bjarke ; Overgaard, Søren ; Palm, Henrik ; Rogmark, Cecilia LU and Kristensen, Morten Tange LU (2023) In Injury 54(4). p.1191-1197
Abstract

Background: The World Health Organization recommends a minimum of 150 min of moderate intensity exercise per week or 75 min of strenuous activity weekly for adults. Younger hip fracture patients are often assumed less active than the general population, however, knowledge on physical activity (PA) and health-related quality of life (HRQoL) in younger hip fracture patients is limited. Objectives: We aimed to 1) investigate the variation in pre-fracture PA for adult patients with hip fractures under the age of 60; and 2) to quantify the association with patient characteristics, including outcomes of HRQOL and handgrip strength. Design and methods: A prospective multicenter cohort study of 207 adult hip fracture patients under 60 years... (More)

Background: The World Health Organization recommends a minimum of 150 min of moderate intensity exercise per week or 75 min of strenuous activity weekly for adults. Younger hip fracture patients are often assumed less active than the general population, however, knowledge on physical activity (PA) and health-related quality of life (HRQoL) in younger hip fracture patients is limited. Objectives: We aimed to 1) investigate the variation in pre-fracture PA for adult patients with hip fractures under the age of 60; and 2) to quantify the association with patient characteristics, including outcomes of HRQOL and handgrip strength. Design and methods: A prospective multicenter cohort study of 207 adult hip fracture patients under 60 years admitted to four study hospitals from July 2015 to December 2018. Data was collected through medical records, questionnaires, physical tests and interviews. PA level was assessed using a validated questionnaire from the Swedish National Board of Health and Welfare, providing a total score from 3 to 19. A score ≥11 corresponds to fulfillment of the WHO recommendation for weekly PA. Handgrip strength was measured in kilograms using a handheld dynamometer following a standardized protocol. Recall pre-fracture HRQoL was assessed using the EQ-5D-3L questionnaire. Results: Fifty-nine percent had a PA score ≤10 out of these 46% had an ASA grade of 3 or 4, 38% had a BMI over 25 and 81% had a low energy fracture. A PA score ≤10 was associated with a lower HRQoL compared to those who had a PA score ≥11. PA score ≤10 points was associated with weaker hand grip strength and a worse health status (higher ASA-grade) p<0.001. Conclusion: We found that close to two-thirds of the patients had a pre-fracture PA level below WHO recommendations. Being more active was associated with better handgrip strength, HRQoL, and ASA score. Our findings indicate that individuals under 60 years who sustain a hip fracture form a heterogeneous group, some severely comorbid and others highly active and seemingly healthy. This suggests a more nuanced approach to rehabilitation, as the more active patient might need a more individualized plan than the standard program can offer.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Handgrip strength, Health related quality of life, Hip fracture, Physical activity, Rehabilitation
in
Injury
volume
54
issue
4
pages
1191 - 1197
publisher
Elsevier
external identifiers
  • pmid:36759311
  • scopus:85147660933
ISSN
0020-1383
DOI
10.1016/j.injury.2023.01.037
language
English
LU publication?
yes
id
d4982664-6c60-4c8c-b262-063934ea7053
date added to LUP
2023-02-21 09:43:01
date last changed
2024-06-13 17:13:07
@article{d4982664-6c60-4c8c-b262-063934ea7053,
  abstract     = {{<p>Background: The World Health Organization recommends a minimum of 150 min of moderate intensity exercise per week or 75 min of strenuous activity weekly for adults. Younger hip fracture patients are often assumed less active than the general population, however, knowledge on physical activity (PA) and health-related quality of life (HRQoL) in younger hip fracture patients is limited. Objectives: We aimed to 1) investigate the variation in pre-fracture PA for adult patients with hip fractures under the age of 60; and 2) to quantify the association with patient characteristics, including outcomes of HRQOL and handgrip strength. Design and methods: A prospective multicenter cohort study of 207 adult hip fracture patients under 60 years admitted to four study hospitals from July 2015 to December 2018. Data was collected through medical records, questionnaires, physical tests and interviews. PA level was assessed using a validated questionnaire from the Swedish National Board of Health and Welfare, providing a total score from 3 to 19. A score ≥11 corresponds to fulfillment of the WHO recommendation for weekly PA. Handgrip strength was measured in kilograms using a handheld dynamometer following a standardized protocol. Recall pre-fracture HRQoL was assessed using the EQ-5D-3L questionnaire. Results: Fifty-nine percent had a PA score ≤10 out of these 46% had an ASA grade of 3 or 4, 38% had a BMI over 25 and 81% had a low energy fracture. A PA score ≤10 was associated with a lower HRQoL compared to those who had a PA score ≥11. PA score ≤10 points was associated with weaker hand grip strength and a worse health status (higher ASA-grade) p&lt;0.001. Conclusion: We found that close to two-thirds of the patients had a pre-fracture PA level below WHO recommendations. Being more active was associated with better handgrip strength, HRQoL, and ASA score. Our findings indicate that individuals under 60 years who sustain a hip fracture form a heterogeneous group, some severely comorbid and others highly active and seemingly healthy. This suggests a more nuanced approach to rehabilitation, as the more active patient might need a more individualized plan than the standard program can offer.</p>}},
  author       = {{Lindestrand, Anna Gaki and Rönnquist, Sebastian Strøm and Viberg, Bjarke and Overgaard, Søren and Palm, Henrik and Rogmark, Cecilia and Kristensen, Morten Tange}},
  issn         = {{0020-1383}},
  keywords     = {{Handgrip strength; Health related quality of life; Hip fracture; Physical activity; Rehabilitation}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{1191--1197}},
  publisher    = {{Elsevier}},
  series       = {{Injury}},
  title        = {{Physical activity in young hip fracture patients is associated with health-related quality of life and strength; results from a multicenter study}},
  url          = {{http://dx.doi.org/10.1016/j.injury.2023.01.037}},
  doi          = {{10.1016/j.injury.2023.01.037}},
  volume       = {{54}},
  year         = {{2023}},
}