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JFSF Vol 6, No 2, June 2021, p.66-78

doi: 10.22540/JFSF-06-066

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Original Article

Implementing grip strength assessment in hip fracture patients: a feasibility project

William J. Doherty1, Thomas A. Stubbs1, Andrew Chaplin2, Sarah Langford2, Nicola Sinclair2, Kinda Ibrahim3, Mike R. Reed2, Avan A. Sayer1, Miles D. Witham1*, Antony K. Sorial2,4*

  1. AGE Research Group, NIHR Newcastle Biomedical Research Centre, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University and Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  2. Department of Trauma and Orthopaedics, Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK
  3. Academic Geriatric Medicine, NIHR Wessex Applied Research Collaboration, Faculty of Medicine, University of Southampton, Southampton, UK
  4. Institute for Cell and Molecular Biosciences, Newcastle University, International Centre for Life, Newcastle upon Tyne, UK
  • * equal contribution

Keywords: Feasibility, Grip strength, Hip fracture, Implementation, Sarcopenia

Abstract

Objectives: Risk stratification scores are used in hip fracture surgery, but none incorporate objective tests for low muscle strength. Grip strength testing is simple and cheap but not routinely assessed for patients with hip fracture. This project aimed to assess the feasibility of implementing grip strength testing into admission assessment of patients with hip fracture. Methods: A scalable protocol and a corresponding training programme of instructional presentations and practical assessments were designed and delivered by and for physiotherapy staff. Grip strength values were collected pre-surgery on patients with hip fracture at a single centre whilst supine in bed. Implementation of the process was evaluated using narrative, quantitative and cost measures. Results: 53 hip fracture patients with a mean age 80.6 (SD 10.4), of which 36 (67.9%) were female, were included. Testing was offered to 42/52 (81%) patients. Cognitive impairment prevented 14/42 (33%) of patients from completing testing; one patient declined testing. Of the 27 patients who completed testing, 14/27 (52%) had low grip strength as defined by EWGSOP2 criteria. The projected cost of testing for one year was £2.68-£2.82 per patient. Fidelity to the protocol was high using multiple criteria. Conclusions: Grip strength assessment is acceptable to physiotherapy staff and can be rapidly and cost-effectively implemented into hip fracture admission assessment.