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Hip muscle and hand-grip strength to differentiate between older fallers and non-fallers: a cross-sectional validity study

Authors Gafner SC, Bastiaenen CH, Ferrari S, Gold G, Terrier P, Hilfiker R, Allet L

Received 20 July 2017

Accepted for publication 7 November 2017

Published 21 December 2017 Volume 2018:13 Pages 1—8

DOI https://doi.org/10.2147/CIA.S146834

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Richard Walker


Simone C Gafner,1,2 Caroline H Bastiaenen,2,3 Serge Ferrari,4 Gabriel Gold,5 Philippe Terrier,6,7 Roger Hilfiker,8 Lara Allet1,9

1Department of Physiotherapy, HES-SO University of Applied Sciences and Arts of Western Switzerland, Geneva, Switzerland; 2Department of Epidemiology, Research Program Functioning and Rehabilitation, CAPHRI, Maastricht University, Maastricht, the Netherlands; 3Department of Health, School of Health Professions, Zurich University of Applied Sciences, Winterthur, 4Department of Internal Medicine Specialties, 5Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals and University of Geneva, Geneva, 6Department of Research, Clinique romande de réadaptation SUVACare, 7Department of Research, Institute for Research in Rehabilitation, Sion, 8Department of Physiotherapy, School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts of Western Switzerland, Valais, 9Department of Community Medicine, University Hospitals and University of Geneva, Geneva, Switzerland


Background: Hip muscle weakness in older people seems to be an influencing factor of falls. Currently, it is unclear which muscles out of the hip muscle group play an important role in older people. A validating process in the measurement regarding muscle strength related to falls is necessary before answering that question.
Objective: Firstly, we aimed to investigate which hip muscle group strength shows an acceptable level of distinction between older adult fallers and non-fallers compared to a predefined external criterion regarding falling. Secondly, we aimed to compare the same outcomes and questions for hand-grip strength in relation to the same external criterion.
Design: This study was a cross-sectional validity study.
Methods: The maximum voluntary isometric strength (MVIS) and the rate of force generation of hip abductors (ABD), adductors, internal and external rotators, extensors, and flexors were measured with a dynamometer fixed to a custom-made frame as well as hand-grip strength with a Martin Vigorimeter in 60 older people aged over 65 years (38 females and 22 males).
Results: The area under the curve (AUC) and the results of the mean decrease in Gini index assessed by random forest approach show that of all the assessed parameters, hip ABD MVIS showed the highest discriminative value regarding the chosen external criterion in older people (AUC ABD MVIS 0.825, 95% confidence interval: 0.712–0.938).
Conclusion: Results indicate that ABD MVIS is a useful measure to distinguish between older adult fallers and non-fallers regarding the chosen external criterion.

Keywords: hip muscle strength, accidental falls, older adults, hand-grip strength, measurement study

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