Physical Activity and Hip Fracture Disability: A Review

Table 3

Over 20-years of research evidence showing degree of physical activity participation is a consistent predictor of hip fracture risk in the context of cross-sectional (Level III), case control (Level III), systematic reviews and prospective (Level II) studies as categorized according to Oxford Centre for Evidence-Based Medicine quality criteria.

Authors and year	Study design	Finding
Lau et al. [13], 1999	Case-control study of 400 Chinese men and women with hip fractures and 800 controls.	Daily walking outdoors, upstairs, uphill, or with a load protected against sustaining a hip fracture, as did higher levels of reported activity in middle life.
Cooper et al. [83], 1988	Case control study of 300 elderly men and women with hip fracture and 600 controls matched for age and sex.	Daily general and weight bearing activity protected against sustaining a hip fracture.
Coupland et al. [122], 1993	Population based, case-control study of 197 patients older than 50 years with hip fracture and 382 controls matched by age and sex.	Customary physical inactivity increased the risk for sustaining a hip fracture in the elderly.
Grisso et al. [123], 1997	Case-control study of 34 hospitals and 356 men with first hip fracture and 402 control men matched for age and geographic location.	Physical activity was markedly protective against sustaining a hip fracture.
Kanis et al. [125], 1999	Case-control study of 730 European men with hip fracture and 1132 age-stratified controls followed prospectively.	Decreased physical activity and exposure to sunlight accounted for the highest attributable risks for sustaining a hip fracture among a number of different risk factors.
Farahmand et al. [127], 2000	Population based case-control study of 1,327 women with hip fracture and 3,262 randomly selected controls.	There was a protective effect against sustaining a hip fracture of recent leisure-associated physical activity.
Suriyawongpaisal et al. [121], 2001	Case-control study of 187 Thai men over 51 years of age with hip fracture and 177 age-matched community controls.	Physical activity was independently associated with reduced risk of sustaining a hip fracture after controlling for confounding factors.
Englund et al. [128], 2010	Nested case-control study investigating associations between bone markers, lifestyle, and osteoporotic fractures that identified 81 female hip fracture cases that had reported lifestyle data before they sustained their fracture. Each case was compared with two female controls identified from the same cohort and matched for age.	An active lifestyle in middle age seems to reduce the risk of future hip fracture.
Wickham et al. [82], 1989	15-year prospective study of 1,688 community dwelling subjects.	Physical activity participation protected against hip fracture.
Gregg et al. [124], 1998	Prospective study of 9,704 nonblack women 65 years of age or older.	Among older community-dwelling women, physical activity is associated with a reduced risk for sustaining a hip fracture.
Kujala et al. [126], 2000	Prospective study of 3,262 men, 44 years or older followed for 21 years, or from age 50 for subjects initially younger than 50 years.	There is an inverse association between baseline physical activity and future hip fracture risk among men.
Høidrup et al. [129], 2001	Prospective study of leisure-time physical activity levels and changes in relation to risk of hip fracture among 1,211 men and women with first hip fractures.	Moderate levels of physical activity appear to protect against later hip fracture.
		Declining physical activity over time is an important risk factor for hip fracture.
Devine et al. [130], 2004	A population based sample underwent bone mass measures and answered surveys about their nutrition and physical activity practices.	A high level of physical activity and calcium consumption was associated with a higher hip bone mineral density.
Feskanich et al. [131], 2002	Prospective study to assess the relationship of walking, leisure-time activity, and risk of hip fracture among 51,200 postmenopausal women.	Moderate levels of activity, including walking, are associated with substantially lower risk of hip fracture.
Morita et al. [132], 2005	157 women with hip fractures were followed between 1989–1993; 216 were followed between 199–2000.	For prevention of hip fractures it is important to improve physical function to void falls.
Michaelsson et al. [120], 2007	Longitudinal, population-based study of 2,205 men.	Regular sports activities can reduce the risk of hip fractures in older men by one third.
Moayyeri [99], 2008	Meta-analysis of 13 prospective cohort studies.	Moderate to vigorous physical activity is associated with a hip fracture risk reduction of 45% and 38% among men and women.
Cawthon et al. [133], 2008	Prospective study of performance on 5 physical function exams among 5902 men 65 years of age or older.	Poor physical performance was associated with an increased risk of sustaining a hip fracture.
Trimpou et al. [134], 2010	Prospective study of hip fractures in 7,496 men aged 46–56 years.	High degree of leisure-time physical activity, high occupational class, and high BMI protected against sustaining a hip fracture. However, work-related physical activity was not protective.