AbstractBackgroundPast research has not investigated both lower-extremity power and upper-extremity strength in the same fall injury study, particularly nonfracture fall injuries.MethodsIn the Osteoporotic Fractures in Men Study (baseline: N = 5 994; age 73.7 ± 5.9 years; 10.2% non-White), fall injuries (yes/no) were assessed prospectively with questionnaires approximately every 3 years over 9 years. Maximum leg power (Watts) from Nottingham single leg press and maximum grip strength (kg) from handheld dynamometry were assessed at baseline and standardized to kg body weight. Physical performance included gait speed (6-m usual; narrow walk) and chair stands speed.ResultsOf men with ≥1/4 follow-ups (N = 5 178; age 73.4 ± 5.7 years), 40.4% (N = 2 090) had ≥1 fall injury. In fully adjusted repeated-measures logistic regressions, lower power/kg and grip strength/kg had higher fall injury risk (trend across quartiles: both p < .0001), with lower quartiles at significantly increased risk versus highest Q4 except for grip strength Q3 versus Q4. Fall injury risk was 19% higher per 1 standard deviation (SD) lower power/kg (95% confidence interval [CI]: 1.12–1.26) and 16% higher per SD lower grip strength/kg (95% CI: 1.10–1.23). In models including both leg power/kg and grip strength/kg, odds ratios (ORs) were similar and independent of each other and physical performance (leg power/kg OR per SD = 1.13, 95% CI: 1.06–1.20; grip strength/kg OR per SD = 1.11, 95% CI: 1.05–1.17).ConclusionsLower leg power/kg and grip strength/kg predicted future fall injury risk in older men independent of physical performance. Leg power potentially identifies fall injury risk better than grip strength at higher muscle function, though grip strength may be more suitable in clinical/practice settings.

中文翻译：

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小腿力量和握力与老年男性跌倒受伤风险增加相关：男性骨质疏松性骨折研究

摘要背景过去的研究尚未在同一项跌倒损伤研究中同时调查下肢力量和上肢力量，特别是非骨折跌倒损伤。方法在男性骨质疏松性骨折研究中（基线：N = 5 994；年龄 73.7 ± 5.9 岁；10.2% 非白人），在 9 年中大约每 3 年通过问卷调查对跌倒伤害（是/否）进行前瞻性评估。在基线处评估诺丁汉单腿推举的最大腿部力量（瓦）和手持式测力计的最大握力（公斤），并标准化为公斤体重。身体表现包括步态速度（通常为 6 米；狭窄的步行）和椅子站立速度。结果在 ≥1/4 次随访的男性中（N = 5 178；年龄 73.4 ± 5.7 岁），40.4% (N = 2 090) 遭受过 ≥ 1 次跌倒伤害。在完全调整的重复测量逻辑回归中，较低的力量/公斤和握力/公斤具有较高的跌倒受伤风险（四分位数趋势：均 p < .0001），与最高的 Q4 相比，除了握力之外，较低四分位数的风险显着增加Q3 与 Q4。每公斤力量每降低 1 个标准差 (SD)，跌倒受伤风险就会增加 19%（95% 置信区间 [CI]：1.12–1.26），握力每公斤每减少 1 个标准差，跌倒受伤风险就会增加 16%（95% CI：1.10–1.23） ）。在包括腿部力量/公斤和握力/公斤的模型中，比值比 (OR) 相似且彼此独立且与身体表现无关（腿部力量/公斤 OR 每 SD = 1.13，95% CI：1.06–1.20；握力/kg OR 每 SD = 1.11，95% CI：1.05–1.17）。结论小腿力量/公斤和握力/公斤可预测老年男性未来跌倒受伤的风险，与身体表现无关。在较高的肌肉功能下，腿部力量可能比握力更好地识别跌倒受伤风险，尽管握力可能更适合临床/实践环境。