Ортопедическая и мышечная система: текущие исследования
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Hip Flexor and Knee Extensor Muscle Strength Characteristics of Community- Dwelling Women with Recent Hip Fractures: A Case Study of Extent of Persistent Inter and Intra-limb Strength Assymetries

Ray Marks

Objectives: To examine the profile of hip flexor and knee extensor strength measures among other factors in the context of recovery from an acute hip fracture among a sample of six community dwelling otherwise healthy women.

Methods: Records of the hip flexor and knee extensor strength of six women with right-sided hip fractures followed up for six months were analyzed.

Results: All women presented with interlimb strength assymetries at all stages of their rehabilitation program, as well as intralimb differences in recovery rates between the hip and knee muscles. While strength improved in most cases, this was not consistent within or across subjects, and was significant between 6 weeks and 6 months only for the uninjured side (p<0.05). Those with better hip flexor symmetry strength scores at six months had more rapid Get Up and Go scores, (p=.008), number of walking laps competed was higher (p=.049). Hip flexor muscle strength on the uninjured side at 6 months independently predicted the subject’s ability to rise from a chair as rapidly as possible, and knee strength on the uninjured side predicted walking distance (p<.05).

Conclusion: Hip flexor and knee extensor strength deficits of the affected leg are still evident among community dwelling hip fracture cases at six months, regardless of whether subjects take part in intensive exercise interventions or not. The presence of hip flexor and knee extensor strength deficiencies and assymetries from side to side which prevail for an extended period after surgical repair influences overall functional ability at 6 months. Implications: Improving leg strength after hip fracture surgery requires careful baseline and ongoing periodic evaluations and tailored prolonged interventions to avert the increased risk of falling and sustaining second hip fractures associated with suboptimal muscle strength of the legs. Optimally reducing interlimb and intralimb discrepancies in hip flexor and knee extensor muscle strength can be expected to improve functional ability.