Abstract
BackgroundOlder adults with concurrent low back and hip pain are predisposed to reductions in physical performance and health-related quality of life. Yet no study to date has assessed whether or not coexisting hip impairments increase fall risk in older adults with chronic low back pain (CLBP). The objective of this study was to determine if hip osteoarthritis (OA) signs and symptoms per American College of Rheumatology (ACR) criteria are associated with fall risk over a 1-year span.MethodsFalls were prospectively monitored for 1 year via fall calendars. Age, sex, body mass index (BMI), anxiolytic use, balance confidence, LBP-related disability, and prior fall history were identified as covariates. Hip pain, pain with hip internal rotation (IR), hip IR range of motion (ROM) ≥ 15°, and morning stiffness lasting ≤ 60 min were evaluated at baseline and summed to represent hip OA impairment burden. A generalized linear model with a Poisson distribution and log link function assessed the association between ACR criteria and fall risk beyond established covariates. As a secondary analysis, binary logistic regression assessed ACR criteria and the odds of falling two or more times within a year.ResultsData from two-hundred and ten participants were analyzed. Hip OA signs and symptoms were present in 97.1% of the participants, and hip OA impairment burden was significantly greater (p < 0.050) in participants who fell ≥ 2 times compared to single and non-fallers. Higher hip OA impairment burden was associated with significantly increased fall risk (p = 0.001, risk ratio = 1.23, 95% CI 1.09–1.38) and odds of falling multiple times (p < 0.05, odds ratio = 1.41, 95% CI 1.01–1.95) after adjustment for covariates.ConclusionsOlder adults with CLBP and concomitant hip impairments are an at-risk group for falling. Healthcare professionals should employ falls screening and preventive measures to avoid negative sequelae in this vulnerable population.
Highlights
Older adults with concurrent low back and hip pain are predisposed to reductions in physical performance and health-related quality of life
Hicks et al [7] demonstrated that hip osteoarthritis (OA) signs and symptoms, as defined by American College of Rheumatology (ACR) criteria [8], are associated with poorer performance on physical function tests beyond the influence of chronic low back pain (CLBP) alone; they are associated with higher disability and reduced health-related quality of life in this patient population [9]
These findings are consistent with prior evidence on more distal health outcomes in older adults; hip OA has been established as a risk factor for falling and is associated with elevated annual fall prevalence compared to national estimates of falls in older adults [11, 12]
Summary
Older adults with concurrent low back and hip pain are predisposed to reductions in physical performance and health-related quality of life. Hicks et al [7] demonstrated that hip osteoarthritis (OA) signs and symptoms, as defined by American College of Rheumatology (ACR) criteria [8], are associated with poorer performance on physical function tests beyond the influence of CLBP alone; they are associated with higher disability and reduced health-related quality of life in this patient population [9]. Rundell et al [10] corroborate this association, as they report that older adults with coexisting hip OA and back pain had worse disability health-related quality of life than older adults with LBP alone These findings are consistent with prior evidence on more distal health outcomes in older adults; hip OA has been established as a risk factor for falling and is associated with elevated annual fall prevalence compared to national estimates of falls in older adults [11, 12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
