Handgrip strength predicts persistent walking recovery after hip fracture surgery

Background In older people, hip fractures often lead to disability and death. We evaluated handgrip strength, an objective measure of physical function for bedridden patients, as a predictor of walking recovery in the year after fracture surgery. Methods This multicenter prospective cohort study included 504 patients aged 70 years and older, who were admitted to the hospital for hip fracture surgery and were formerly able to walk independently. A multidimensional geriatric evaluation that included a physical examination, Short Portable Mental Status Questionnaire (SPMSQ), Geriatric Depression Scale (GDS), Charlson Index, Basic Activities of Daily Living (BADL), and grip strength was administered at the time of admission. Follow-ups were performed every three months for one year after surgery to assess functional status and survival. The walking recovery probability was evaluated using multivariable logistic regression models. Results The mean age of the participants was 85.3±5.5 years, and 76.1% of the participants were women. The mean grip strength was greater in men (β: 6.6±0.62, p<0.001) and was directly related to the SPMSQ results (p<0.001), BADL results (p<0.001), serum vitamin D levels (p=0.03), and time before surgery (p<0.001), whereas it was inversely related to age (p<0.001), GDS score (p<0.001), and Charlson Index (p<0.001). After adjusting for confounders, the grip strength was directly associated with the probability of both incident and persistent walking recovery (OR highest tertile vs. lowest tertile: 2.84, C.I. 1.76; 4.59 and 2.79, C.I. 1.35; 5.79, respectively). Conclusions In older patients with hip fractures, early grip strength evaluation might provide important prognostic information regarding the patient’s future functional trajectory.