Clinical assessment tools identify functional deficits in fragility fracture patients

Abstract

Purpose

To identify inexpensive, noninvasive, portable, clinical assessment tools that can be used to assess functional performance measures that may put older patients at risk for falls such as balance, handgrip strength, and lumbopelvic control.

Patients and methods

Twenty fragility fracture patients and 21 healthy control subjects were evaluated using clinical assessment tools (Nintendo Wii Balance Board [WBB], a handheld dynamometer, and an application for the Apple iPod Touch, the Level Belt) that measure functional performance during activity of daily living tasks. The main outcome measurements were balance (WBB), handgrip strength (handheld dynamometer), and lumbopelvic control (iPod Touch Level Belt), which were compared between fragility fracture patients and healthy controls.

Results

Fragility fracture patients had lower scores on the vertical component of the WBB Torso Twist task (P=0.042) and greater medial–lateral lumbopelvic sway during a 40 m walk (P=0.026) when compared to healthy controls. Unexpectedly, the fracture patients had significantly higher scores on the left leg (P=0.020) and total components (P=0.010) of the WBB Single Leg Stand task as well as less faults during the left Single Leg Stand task (P=0.003).

Conclusion

The clinical assessment tools utilized in this study are relatively inexpensive and portable tools of performance measures capable of detecting differences in postural sway between fragility fracture patients and controls.

Keywords:

• fall risk
• geriatric fracture
• Nintendo Wii Balance Board
• Level Belt
• fragility fracture

Acknowledgments

The authors thank the staff of The Ohio State University Hand and Upper Extremity Center, Martha Morehouse, and Carepoint East for their help in the completion of this study. This work was supported in part by The Ohio State University College of Medicine Roessler Research Scholarship (TDA).

Disclosure

The authors report no conflicts of interest in this work.