Two leg tests may be able to predict a postmenopausal woman’s likelihood of suffering a hip fracture, according to a 15-year study presented at the American Society for Bone and Mineral Research annual meeting.
The first test involves standing on one leg for 10 seconds, and the second test requires a person to squat down and pick an object up off the floor. If the tester cannot complete the activities, she is at an increased risk for a hip fracture.
“Squatting down to reach a floor and maintaining balance on 1 foot for a moment are essential functional abilities and very simple to measure,” said study author Toni Rikkonen, PhD. “Inability to accomplish either of them demonstrates functional decline with increased risk of mortality and fractures.”
Hip Study
For their study, researchers analyzed 2,791 with a mean average of 59.1 years. The women were asked to preform three baseline tests; the two mentioned above and a grip strength test. Just over half the women (1,587) showed no signs of physical deterioration in any of the three tests, but the others failed one or more of the tests.
Researchers followed up with the women on average 13.1 years after the baseline tests were preformed and examined any medical complications that occurred between the two dates. There were 578 fractures, including 35 hip fractures. When comparing the two groups, researchers noted that the women who failed one or more tests during baseline testing were significantly more likely to have suffered a hip fracture. Mortality risk and general fracture risk were also more common in the women who failed at least one baseline test.
Researchers noted that the one-leg stand test was the best predictor of hip fracture risk, followed by the squat test. The grip test was the weakest predictor of the three tests.
“The inability to stand on 1 foot is mostly dependent on balance and coordination. In addition, unilateral posture demands your hip and core muscles to compensate accordingly with the task and to provide additional support for the body,” Dr. Rikkonen explained. “Standing on 1 foot challenges both of these properties, muscle coordination and balance, which might explain having the most predictive value among tests.”
He concluded by saying that women can improve their functional limitations.
“Functional limitations are usually modifiable,” Dr. Rikkonen said. “These patients should be encouraged to use their legs and train their balance in a safe manner, regardless of their age.”
Dr. Silverman comments
I love the KISS principle. Keep it simple silly (and other versions).
These simple tests have the ability to help predict hip fracture risk. While there are confounding variables that might actually make a single leg balance in my office not so accurate (like foot or ankle pain), I am excited to add these tests to my routines in elderly patients. We know that core strength can be improved with training and physical therapy. I should be able to identify patients in need of physical therapy much more easily with these tests.
Related source: Medscape