Copers were not different in any meaningful way from the noncopers before injury, had equal or greater side-to-side laxity differences, and functioned normally. A battery of tests was identified that accurately discriminated noncopers from copers even early after injury. Thus, measurements of laxity alone are insufficient for determining functional status after ACL injury.

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The purpose of this study was to test a model of the factors influencing physical activity, physical function and physical performance at 2 months post hip fracture and compare model fit between men and women. Age, cognitive status, comorbidities, pain, resilience, bone mineral density, total body lean mass, total body fat and grip strength were hypothesized to be directly and/or indirectly related to physical activity, physical function and physical performance. This analysis used data from the seventh Baltimore Hip Studies (BHS-7), a prospective cohort study that included 258 community-dwelling participants, 125 (48%) men and 133 (52%) women, hospitalized for treatment of a hip fracture; survey and objective data were obtained at 2 months post hip fracture. In addition to age, sex and comorbidities (modified Charlson scale), data collection included body composition from dual-energy x-ray absorptiometry (DXA) scans, grip strength, and physical activity, function and performance based on the Yale Physical Activity Survey, the Short Physical Performance Battery and the Lower Extremity Gain Scale. Age, cognition, and comorbidities were not significantly associated with resilience; and, resilience was not associated with pain. In addition, bone mineral density was not associated with physical activity, physical performance or physical function. Total lean body mass, resilience and pain were associated with physical activity, physical function and physical performance in women, but were not consistently associated with physical and functional outcomes in men. Future research should consider evaluation of muscle quality and additional psychosocial factors (e.g., depression, social supports) in model testing.

The observed asymmetry is consistent with the effect of disuse and inflammation in the affected limb along with training effects in the unaffected limb due to the favoring of this leg with ambulation during the postfracture period.

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The observed asymmetry is consistent with the effect of disuse and inflammation in the affected limb along with training effects in the unaffected limb due to the favoring of this leg with ambulation during the postfracture period.

Background CT-scan measures of muscle composition may be associated with recovery post hip fracture. Methods In an ancillary study to Baltimore Hip Studies 7th cohort, older adults were evaluated at 2 and 6 months post-hip fracture. CT-scan measures of muscle were acquired at 2 months. Short Physical Performance Battery (SPPB) was measured at 2 and 6 months. Generalized estimating equations were used to model the association of muscle measures and physical function, adjusting for age, sex, BMI, and time post fracture. Results Seventy-one older adults (52% males, age 79.6 ± 7.3 yrs) were included. At 2-months, males had greater thigh cross-sectional area (CSA, p<0.0001) and less low density muscle (p=0.047), and intermuscular adipose tissue (p=0.007) than females on the side of the fracture, while females performed better on the SPPB (p= 0.05). Muscle measures on the fractured side were associated with function at 2 months in both sexes. Subjects in the lowest tertile of muscle CSA difference at 2-months, indicating greater symmetry in CSA between limbs, performed better than the other two tertiles at 6-months. Males performed worse in functional measures at baseline and did not recover as well as females (p= 0.02). Conclusions CT-scan measures of muscle CSA and fatty infiltration were associated with function at 2-months post-hip fracture and with improvement in function by 6 months. Observed sex differences in these associations suggest that rehabilitation strategies may need to be adapted by sex after hip fracture.