Balance confidence and functional balance are associated with physical disability after hip fracture

BackgroundThis cross-sectional study investigated the associations between balance confidence, functional balance, and physical disability among older people after hip fracture.Material and methodsThe study utilizes baseline data of two randomized controlled trials (ISRCTN34271567 and ISRCTN53680197). The participants were 159 community-dwelling over 60-year-old people. Health, fracture status, the date and type of surgery, and contraindications for participation were assessed in a clinical examination. Balance confidence was assessed by the Activities-specific Balance Confidence Scale (ABC) and functional balance by the Berg Balance Scale. Physical disability was assessed by a questionnaire containing 14 questions on perceived difficulty in basic (ADL) and instrumental activities of daily living (IADL). Two sum scores were composed: ADL score (range 0-6) and IADL score (range 0-8). Isometric knee extension force was measured using a dynamometer. Pain and use of walking aids were assessed by a questionnaire. The negative binomial regression analysis was used to analyze the associations.ResultsA higher ABC score was associated with a lower risk for ADL (IRR 0.99; 95% CI 0.98-0.99) and IADL disability (0.99; 0.98-0.99) in the fully adjusted models. Also a higher BBS score was associated with a lower risk for ADL (0.98; 0.96-0.99) and IADL disability (0.98; 0.97-0.99) in the fully adjusted models.ConclusionDecreased balance confidence and impaired functional balance are associated with physical disability in older people after hip fracture.

► This study investigated the associations between balance confidence, functional balance, and physical disability. ► The participants were 159 community-dwelling over 60-year-old people who had sustained a hip fracture. ► Decreased balance confidence and impaired functional balance were associated with physical disability in older people after hip fracture. ► The ABC scale may potentially be used more often as a screening tool for impaired functional balance in clinical practice.