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We studied 40 previously healthy women (median age 83 years 90% central range 77-90) 1 week after surgical fixation of their proximal femoral fracture to establish the significance of leg extensor power, postural sway, age, pre-injury mobility and fracture type in recovery of walking and stair-climbing ability. Subjects demonstrated a range of walking and stair-climbing abilities. Those not mobile all had sway greater than 40.9 cm/1 min and were more likely to have suffered a trochanteric fracture (p < 0.05). These subjects were not the oldest or those with the worst pre-injury mobility, but did report much greater pain (p < 0.05). Multiple linear regression revealed leg extensor power in the fractured leg (LEPf) to be the most important determinant of walking speed (R2 0.40, p < 0.001) and stair climbing time (R2 0.33, p < 0.002). LEPf was less than in the uninjured leg (p < 0.001), and accounted for only 30% of the total power output. LEPf was determined by pain, and not pre-injury mobility or fracture pattern. These findings have implications for the development of rehabilitation programmes.

Type

Journal article

Journal

Age Ageing

Publication Date

07/1995

Volume

24

Pages

308 - 314

Keywords

Activities of Daily Living, Aged, Aged, 80 and over, Exercise Test, Female, Follow-Up Studies, Fracture Fixation, Internal, Geriatric Assessment, Hip Fractures, Humans, Muscle, Skeletal, Postoperative Complications, Postural Balance, Posture, Range of Motion, Articular, Walking, Weight-Bearing