A 5-year follow-up was performed on a group of persons, 50 years and above, with previous wrist fracture, from a previous study about vestibular rehabilitation for persons with wrist fracture [8].
Participants
In total, 83 patients were included in the study, 79 women and 4 men, 54–79 years old (SD ± 9), all had a wrist fracture. The skew of gender distribution is in line with the difference in frequency of wrist fractures between males and females [9].
Measures
Balance was assessed with five clinical balance measures and in terms of postural sway. The clinical balance measures were:
Tandem standing with open and closed eyes, were time up to 30 seconds was measured [10–12]. Three attempts were allowed and the best attempt was used.
Standing one leg with eyes open (SOLEO) and with eyes closed (SOLEC) [11, 13, 14]. Time, up to 30 seconds was measured and three attempts were allowed, the best attempt used.
Walking in the modified figure of eight, were steps outside the line was counted [15].
Five times sit-to stand test, were the participants sits on a chair, stands up and sits down five times as fast as possible. Time in second is measured [16, 17].
Postural sway was assessed by a force plate, which measures the mean value for in which speed (mm/s) that center of pressure is changed in the medio-lateral and in the anterio-posterior direction in quiet standing. Measures of postural sway on a force plate had shown to have good test-retest reliability as well as good intrasession reliability [18, 19].
Function of the inner ear was measured by the head-shake test, using Video-Frenzl goggles. The test indicates vestibular asymmetry when three or more saccades are visible [7].
Self-rated health was measured with the visual analogue scale included in the generic instrument EQ5D [20]. The participant were asked to rate their health on a vertical scale, where 100 was the best imaginable state of health and 0 was the worst.
To assess the risk for future fractures, the FRAX® tool was used. FRAX calculate the 10-year probability of hip fracture and the 10-year probability of a osteoporotic fracture. A value of < 5 is considered as low fracture risk, value between ≥ 5 and < 7.5 is considered as intermediate risk and value of ≥ 7.5 is considered as high risk [21].
Proceedure
The participants were first informed about the study and then invited to participate at the time of visiting the orthopedic clinic in Malmö for removing the cast after a wrist fracture. Those who wanted to participate in the study was given an appointment to physiotherapist in primary health care in Malmö, were informed and written consent was obtained and assessments performed. Data were collected between December 2008 and November 2012. More details about the participants and recruitment has been described previously [4, 8].
Searches in the local health authority’s patient administrative system (PAS) were performed 5 years after inclusion and baseline measurements were taken. Information was extracted about whether participants had been treated for a fracture or hospitalized for any other reason during the 5-year period.
Statistics
Analysis were performed using SPSS and an online calculator for chi square [https://www.socscistatistics.com/tests/chisquare/]. Binary outcome of fracture was analysed with multivariate logistic regression. The outcome variable was fracture of any kind (yes vs. no) and the independent variables were age and BMI. To analyse differences between groups, a chi-square test was used for fracture vs. positive or negative head shake test. Two-sided t-test was used to analyse differences in mean values of SOLEO and SOLEC. Because of the characteristics of the non-normal distribution of FRAX, we employed a Mann-Whitney test.