Sensory impairments and wrist fractures: A case-control study
Bergthora Baldursdottir, Hannes Petersen, Palmi V. Jonsson, Brynjolfur Mogensen, Susan L. Whitney, Alfons Ramel, Ella K. Kristinsdóttir
Department of Physiotherapy, Landspitali University Hospital, 101 Reykjavik, Iceland. E-mail: firstname.lastname@example.org
Objectives: To investigate vestibular function, foot sensation, postural control and functional abilities, and to evaluate whether these variables are associated with fall-related wrist fracture.
Methods: A case-control study was conducted with 98 subjects, age range 50–75 years, who had sustained a fall-related wrist fracture. Forty-eight sex-,
age- and physical activity-matched individuals, with no previous history of wrist fracture, served as controls. Measurements included: head-shake test (HST), tuning fork, biothesiometer, Semmes-Weinstein monofilaments (MF), Sensory Organization Test (SOT), Five-Times-Sit-to-Stand Test (FTSTS), 10-m walk test (10MWT), Activities-specific Balance Confidence (ABC), and the Dizziness Handicap Inventory (DHI) scales. Logistic regression models were used to determine associations of variables with a fall-related wrist fracture.
Results: Vestibular asymmetry was apparent in 82% of wrist fracture subjects and 63% of controls (p = 0.012). Plantar pressure sensation (p <0.001), SOT composite scores (p < 0.001), 10MWT (p <0.001), FTSTS (p <0.001), ABC (p <0.001) and DHI (p <0.005) were significantly poorer among cases than controls. A positive HST (odds ratio (OR) 5.424; p = 0.008) and monofilament sensation (OR 3.886; p = 0.014) showed the strongest associations with having a fall-related wrist fracture.
Conclusion: Asymmetrical vestibular function and reduced plantar pressure sensation are associated with fall-related wrist fractures among the ageing population. These factors are potential targets for future interventions.
People who had broken their wrist, aged between 50 and 75 years, were compared to people who had not broken their wrist. People who broke their wrist were more likely to have problems with their balance system in the inner ears, had less feeling in their feet and worse balance than those who had not broken their wrist. Breaking your wrist is a strong predictor of future fractures, including breaks of the hip bone. Given the importance of prevention of falls and fractures, improving balance, function of the balance system in the inner ear, and feeling in people’s feet, might be helpful to address in a rehabilitation program for persons who have broken one or more of their wrist bones