Lower limb muscle strength and balance in older adults with a distal radius fracture: a systematic review

BMC Musculoskeletal Disorders

Research

Sarah E Lamb¹  Jessica CH Pun²  Matthew L Costa³  Philippa JA Nicolson³  Colin Forde³  David J Keene⁴  Warren Sheehan⁵  Charlotte Vye⁶ 

[1] Exeter Medical School, University of Exeter, Exeter, UK;Institute of Child Health, University College London, London, UK;Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK;Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK;Exeter Medical School, University of Exeter, Exeter, UK;Physiotherapy Department, Oxford University Hospitals NHS Foundation Trust, Oxford, UK;Therapies Department, Royal United Hospitals NHS Foundation Trust, Bath, UK;

关键词: Falls;    Balance;    Muscle strength;    Rehabilitation;    Fragility fracture;    Wrist fracture;    Colles fracture;   

DOI  :  10.1186/s12891-023-06711-4

 received in 2022-10-21, accepted in 2023-07-09,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundDistal radius fractures are common fractures in older adults and associated with increased risk of future functional decline and hip fracture. Whether lower limb muscle strength and balance are impaired in this patient population is uncertain. To help inform rehabilitation requirements, this systematic review aimed to compare lower limb muscle strength and balance between older adults with a distal radius fracture with matched controls, and to synthesise lower limb muscle strength and balance outcomes in older adults with a distal radius fracture.MethodsWe searched Embase, MEDLINE, and CINAHL (1990 to 25 May 2022) for randomised and non-randomised controlled clinical trials and observational studies that measured lower limb muscle strength and/or balance using instrumented measurements or validated tests, in adults aged ≥ 50 years enrolled within one year after distal radius fracture. We appraised included observational studies using a modified Newcastle-Ottawa Scale and included randomised controlled trials using the Cochrane risk-of-bias tool. Due to the clinical and methodological heterogeneity in included studies, we synthesised results narratively in tables and text.ResultsNineteen studies (10 case-control studies, five case series, and four randomised controlled trials) of variable methodological quality and including 1835 participants (96% women, mean age 55–73 years, median sample size 82) were included. Twelve included studies (63%) assessed strength using 10 different methods with knee extension strength most commonly assessed (6/12 (50%) studies). Five included case-control studies (50%) assessed lower limb strength. Cases demonstrated impaired strength during functional tests (two studies), but knee extension strength assessment findings were conflicting (three studies). Eighteen included studies (95%) assessed balance using 14 different methods. Single leg balance was most commonly assessed (6/18 (33%) studies). All case-control studies assessed balance with inconsistent findings.ConclusionCompared to controls, there is some evidence that older adults with a distal radius fracture have impaired lower limb muscle strength and balance. A cautious interpretation is required due to inconsistent findings across studies and/or outcome measures. Heterogeneity in control participants’ characteristics, study design, study quality, and assessment methods limited synthesis of results. Robust case-control and/or prospective observational studies are needed.RegistrationInternational prospective register of systematic reviews (date of registration: 02 July 2020, registration identifier: CRD42020196274).

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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