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Modifiable Determinants of Bone Health in Women With Distal Radius Fracture

Background: Distal radius fracture (DRF) is an early and independent predictor of future osteoporotic (OP) fractures. Currently, there are no studies evaluating the role of modifiable risk factors on OP fracture risk in postmenopausal women (PMW) with DRF. Purpose/Objectives: To determine the extent to which modifiable risk factors such as balance, muscle strength, and physical activity can explain variability in bone mineral density (BMD) among women with DRF. Materials and Methods: The study was designed as a cross-sectional investigation of baseline data. Women aged 50 to 80 years with DRF were assessed for balance, muscle strength (grip strength, plantar flexion), and physical activity using reliable and validated measures. Dual-energy x-ray absorptiometry was used to assess areal BMD at the femoral neck (BMD-FN) and total hip (BMD-TH). Analysis: Stepwise multiple regression analysis was used to determine the extent to which modifiable risk factors (predictors) could explain variability in the BMD (outcome). Results: Women (n = 67; mean age: 62.12 ± 7.45 years) were analyzed. Hand grip strength as an independent predictor explained 15% (F = 11.26, P = .001) and 6% (F = 4.18, P = .04) of total variability in BMD-FN and BMD-TH, respectively. Balance (R2 = .10, F = 4.35, P = .04) and hand grip strength (R2 = .32, F = 10.78, P = .003) explained significant variability in BMD-FN among 50- to 64-year-old (n = 41) and among 65- to 80-year-old (n = 25) PMW with DRF, respectively. Conclusions: Hand grip strength is the independent predictor of femoral neck and total hip BMD in PMW with DRF. Because hand grip strength and balance are modifiable factors that are related to bone health, they may represent useful prevention targets for hand therapists. We recommend evaluation of hand grip strength and balance as a component of OP risk factor assessment among women with DRF.