Purpose: Various factors have been shown to affect the rehabilitation outcome of hip fractured patients. Considering the decrease in muscle mass with aging and its impact on mobility, we hypothesized that a relationship exists between hand grip strength and rehabilitation outcome.
Methods: We retrospectively studied 373 post-hip fracture patients, admitted for rehabilitation. Muscle strength was measured by hand grip dynamometer.
Main outcome measures: functional independence measure motor functional independence measure, motor functional independence measure effectiveness and length of stay). A favorable functional gain was defined as a motor Functional Independence Measure effectiveness score > 0.5. The Spearman correlation assessed the associations between hand grip strength and outcome measures. A multiple linear regression model tested whether hand grip strength was an independent predictor of discharge motor Functional Independence Measure scores and length of stay RESULTS: Significant correlations were found between hand grip strength and functional outcomes. A significant independent association was found between hand grip strength and discharge motor Functional Independence Measure score after adjustment for confounding demographic and clinical variables. High hand grip strength on admission was significantly associated with a greater chance of achieving a favorable functional gain (OR 1.064, 95% CI, 1.01-1.13; p = 0.032). Hand grip strength was not found to be associated with length of stay.
Conclusion: Hand grip strength is independently associated with rehabilitation outcome in post-acute frail hip fractured patients. Initial screening for hand grip strength on admission may help identify patients who require an intensive resistance exercise program.
Keywords: Frail; Hand grip strength; Hip fracture; Older people; Rehabilitation outcomes.