Authors: (including presenting author): :
SIN YH(1), WONG HY(1), YUNG PK(1), CHAN ACM(1), LEE KB(2)
Affiliation: :
(1) Physiotherapy Department, Queen Elizabeth Hospital, Hong Kong (2) Department of Orthopaedics & Traumatology, Queen Elizabeth Hospital, Hong Kong
Keyword 1: :
Handgrip strength
Keyword 2: :
Fragility hip fracture
Keyword 3: :
Elderly Mobility Scale
Keyword 4: :
Stratification
Introduction: :
Patients with Fragility hip fracture (FHF), which place huge burden on public health, usually encounter high mortality, severe loss of mobility and capacity of handling daily activities. Prognostic stratification is essential for physiotherapists to establish realistic therapeutic objectives and tailored interventions to individual patient profiles. Handgrip strength (HGS) is a cost-effective and easily accessible tool to evaluate postoperative functional ability. There are studies on HGS threshold for early ambulation capacity of elderly with hip fracture, and for predicting short-term functional recovery on women with hip fracture. However, there is inadequate study on pre-operative HGS threshold in hip fracture patients for both sexes to predict their short-term functional outcome after operation.
Objectives: :
This study aimed to investigate the contribution of pre-operative HGS in the prediction of independence ambulation capacity in post-operative hip fracture patients.
Methodology: :
A retrospective longitudinal study was conducted. FHF patients attended the Orthopaedic Day Rehabilitation Program (ODRP) in the Queen Elizabeth Hospital (QEH) between April 2024-October 2025 were evaluated. HGS was measured at pre-operative stage. Elderly Mobility Scale (EMS) was assessed at the initial assessment at ODRP (mean days after OT=84.8±39.5 days). Patients with EMS scored 14 or above were classified as independent in functional capacity. Spearman’s rank correlation coefficient was used to explore the relationship between HGS and EMS outcomes. Ordinal regression analysis was conducted to assess the prediction of EMS from HGS. Receiver operating characteristic (ROC) curve analysis was used to assess the predictive capacity of HGS for EMS for functional independence of post-operative hip fracture patients. Youden index was used to find the optimal cut-off point.
Result & Outcome: :
One-hundred and seventy-one patients (mean age=80.3±10.3 years) (46 males,125 females) were reviewed. Positive correlation was found between HGS and EMS (r=0.309, p< 0.001). HGS was found statistically significant to predict EMS (β=0.085, p< 0.001). HGS threshold on EMS for independence ambulation capacity in post-operative hip fracture patients was found to be 18.5kgf for male patients (AUC=0.693, p< 0.05) and 15.5kgf for female patients (AUC=0.655, p< 0.05) respectively. HGS is an objective, cost-effective diagnostic and prognostic tool in hip fracture management. The prognostic value of pre-operative HGS could predict the independence ambulation capacity in post-operative hip fracture patients. Incorporating pre-operative HGS into routine assessment could better stratify patients’ risk and optimize resource for individualized rehabilitation.
