Osteoporosis International

, Volume 19, Issue 8, pp 1203–1210

Association between functional capacity tests and fractures: An eight-year prospective population-based cohort study

  • M. Kärkkäinen
  • T. Rikkonen
  • H. Kröger
  • J. Sirola
  • M. Tuppurainen
  • K. Salovaara
  • J. Arokoski
  • J. Jurvelin
  • R. Honkanen
  • E. Alhava
Original Article



This study of postmenopausal women (n = 2,928) with an eight-year follow-up revealed that impairment in functional status associated with the increased fracture risk. The standing-on-one-foot and grip strength tests and a question about self-assessed ability to move can be used to identify women with a high risk of suffering a fracture.


Poor functional status has pointed to associate with injurious falls and consequent fractures. Our aim was to define association between functional capacity and fractures.


This study was based on the Osteoporosis Risk Factor and Prevention Study (OSTPRE). A total of 2,928 postmenopausal women took part in the functional capacity and muscle strength tests. The duration of fracture follow-up varied from 6.43 to 9.86 (mean 8.37) years and the first fracture was the end-point event for the statistical analyses. All analyses were done with Cox-regression.


A total of 261 end-point fractures occurred. In multivariate analysis the inability to stand-on-one-foot for 10 seconds increased the risk of hip fracture (hazard ratio with 95% CI) 9.11-fold (1.98–42.00). Decreased grip strength associated with 1.05-fold (1.01–1.09) increased risk of hip fractures. Low leg extension strength associated with 1.02-fold (1.00–1.03) higher risk for all fractures. The self-assessed ability to walk less than 100 meters at baseline increased the risk of ankle 2.36-fold (1.10–5.08), hip 11.57-fold (2.73–49.15) and clinical vertebral fractures 3.85-fold (1.45–10.22).


According to these results the standing-on-one-foot less than 10 seconds, grip strength and a question about ability to walk less than 100 meters may help to predict postmenopausal fractures.


Fracture Functional capacity Grip strength Hip fracture Muscle strength Standing-on-one-foot 


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2008

Authors and Affiliations

  • M. Kärkkäinen
    • 1
  • T. Rikkonen
    • 1
  • H. Kröger
    • 1
    • 2
  • J. Sirola
    • 1
    • 2
  • M. Tuppurainen
    • 1
    • 3
  • K. Salovaara
    • 1
    • 2
  • J. Arokoski
    • 4
  • J. Jurvelin
    • 5
  • R. Honkanen
    • 1
  • E. Alhava
    • 6
  1. 1.Bone and Cartilage Research UnitUniversity of KuopioKuopioFinland
  2. 2.Department of Orthopaedics, Traumatology and HandsurgeryKuopio University HospitalKuopioFinland
  3. 3.Department of Obstetrics and GynecologyKuopio University HospitalKuopioFinland
  4. 4.Department of Physical and Rehabilitation MedicineKuopio University HospitalKuopioFinland
  5. 5.Department of Physics, University of Kuopio and Department of Clinical Physiology and Nuclear MedicineKuopio University HospitalKuopioFinland
  6. 6.Institute of Clinical Medicine, Department of SurgeryUniversity of KuopioKuopioFinland

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