Predictors of Gait Speed in Patients after Hip Fracture

Abstract

Purpose: Following hip fracture, patients demonstrate greatly reduced walking speeds 1 year later compared with age-matched elders. The purpose of our study was to examine the factors that relate to gait speed in patients after hip fracture. Methods: Forty-two men and women (mean age 79 AE 7.5 years) who sustained a hip fracture participated in this study. Linear regression analysis was used to determine a statistical model that best predicted gait speed, the dependent variable. Gait speed was measured with a computerized gait mat. The independent variables were age, sex, height, weight, time post-fracture, medications, mental status, depression, balance confidence, Medical Outcome Studies, Short Form (SF-36), balance, and lower extremity isometric force. All subjects were discharged from physical therapy services, and measurements were taken, on average, 17 weeks post-fracture. Results: Using stepwise regression, 72% of the variance in gait speed was explained by summed lower extremity strength normalized by body weight, general health (SF-36), and balance confidence (Activities-specific Balance Confidence Scale). Conclusions: Impairments (summed lower extremity strength) and risk factors (perception of general health and balance confidence) are important predictors of gait speed in elders after hip fracture. RÉ SUMÉ DES POINTS CLÉ SObjectif : Les patients qui subissent une fracture à la hanche marchent beaucoup moins vite un an aprè s une fracture que leurs pairs du mê me â ge. L'objectif de cette é tude est d'examiner les facteurs lié s à la vitesse de la marche chez les patients ayant subi une fracture de la hanche. Me´thodologie : Quarante-deux hommes et femmes (â ge moyen de 79 AE 7,5 ans) ayant subi une fracture à la hanche ont participé à cette é tude. L'analyse de ré gression liné aire a servi à dé terminer un modè le statistique pré voyant le mieux la vitesse de la marche qui constitue la variable dé pendante. La vitesse de la marche a é té mesuré e à l'aide d'un tapis de marche é lectronique. Les variables indé pendantes sont l'â ge, le sexe, la grandeur, le poids, le temps é coulé aprè s la fracture, les mé dicaments, l'é tat mental, la dé pression, la confiance de l'é quilibre, Medical Outcome Studies, Short Form (SF-36), l'é quilibre, et la force isomé trique du membre infé rieur. Pour tous les sujets, les services de physiothé rapie avaient pris fin et les mesures avaient é té prises, en moyenne, 17 semaines aprè s la fracture. Re´sultats : À l'aide de l'analyse de ré gression par degré s, 72 % de la variance dans la vitesse de marche s'expliquaient par une force totale du membre infé rieur normalisé e par le poids corporel, l'é tat de santé (SF-36), et la confiance de l'é quilibre (É chelle de confiance de l'é quilibre spé cifique aux activité s). Conclusions : Les dé ficiences (force totale du membre infé rieur) ainsi que les facteurs de risque (perception de l'é tat de santé gé né ral et de la confiance de l'é quilibre) sont d'importantes variables explicatives de la vitesse de la marc...

Inpatient knee pain after hip fracture surgery affects gait speed in older adults: A retrospective chart‐referenced study

“…Physical function factors known to influence falls include balance function 13 and gait speed 14 . In older adults after hip fracture, age, sex, and cognitive decline have been reported as factors associated with balance function, 15 and sex, type of fracture, knee extensor strength, and cognitive decline have been reported as factors associated with gait speed 16 . The clinical question of this study is whether PHFKP development during hospitalization could be a factor influencing balance function and gait speed.…”

What Makes Us Walk: Predictors and the Interplay of Physical and Cognitive Factors on Gait Speed in Community Dwelling Older Adults

“…These findings add to the body of literature by providing evidence that both are predictive for both comfortable and fast gait speed. The relationship between lower extremity strength and gait speed has been demonstrated primarily using measures of dynamometry [14,18,27,28]. Specifically, knee extensor, hip extensor, and ankle plantarflexor strength have all been shown to have associations with gait speed using these methods [18,28].…”

“…As a result, there is an overall reduction in muscle strength, leading to potential functional mobility limitations and a higher risk for falls and hospitalizations [25]. Multiple studies have identified both composite lower extremity muscle strength and individual muscle strength as predictive variables for comfortable and fast gait speeds [14,18,[26][27][28]. Aranda-Garcia (2015) found that isometric knee extensor strength was the best predictor of fast gait speed in community dwelling older adults, explaining 47.5% of the variance in both global characteristics and physical abilities models.…”