Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Kurose-Gakuendai 555-36, Higashi-Hiroshima, Hiroshima, Japan.
Department of Rehabilitation, Kure Kyosai Hospital, Nishichuo 2-3-28, Kure, Hiroshima, Japan.
J Bone Miner Metab. 2022 Sep;40(5):801-809. doi: 10.1007/s00774-022-01348-0. Epub 2022 Jun 28.
Both hip fracture and bone mineral density (BMD) decline on the non-fractured side are more likely to occur within 1 year. However, there are no longitudinal study reports on the factors associated with BMD maintenance or improvement within the first year after hip fracture. This study aimed to investigate the factors influencing the neck BMD maintenance or improvement in patients with hip fractures from within 2 weeks-6 months after surgery.
Patients were hip fracture after surgery and were divided into two groups: Among neck BMD changes (6 months minus 2 weeks after surgery) were calculated. Based on among neck BMD change, patients were classified into the BMD maintenance or improvement (change ≥ 0) and the BMD decrease groups (change < 0). Propensity score matching was performed to adjust for confounding factors. To predict the factors affecting neck BMD, hierarchical logistic regression analysis was performed. The dependent variable was the BMD maintenance or improvement group and the BMD decrease group. The independent variables were basic and medical information, and physical functions.
The hierarchical logistic regression analysis results showed that movement control during one-leg standing affected femoral neck BMD independently from age, sex. The odds ratio for movement control during one-leg standing was 8.22. The discrimination rate of the model was 69.7%.
This study suggested that adequate movement control during one-leg standing is important to maintain or improve neck BMD.
非骨折侧髋部骨折和骨密度(BMD)下降在 1 年内更有可能发生。然而,目前尚无关于髋部骨折后 1 年内与 BMD 维持或改善相关的纵向研究报告。本研究旨在探讨影响髋部骨折患者术后 2 周至 6 个月内颈 BMD 维持或改善的因素。
患者为术后髋部骨折,分为两组:计算术后 6 个月与术后 2 周时颈 BMD 变化(6 个月减去 2 周手术后)。根据颈 BMD 变化,患者分为 BMD 维持或改善(变化≥0)和 BMD 下降组(变化<0)。采用倾向评分匹配法调整混杂因素。采用分层逻辑回归分析预测影响颈 BMD 的因素。因变量为 BMD 维持或改善组和 BMD 下降组。自变量为基本信息和医疗信息以及身体功能。
分层逻辑回归分析结果表明,单腿站立时的运动控制独立于年龄和性别影响股骨颈 BMD。单腿站立时运动控制的优势比为 8.22。模型的判别率为 69.7%。
本研究表明,单腿站立时适当的运动控制对维持或改善颈 BMD 很重要。