Do men and women recover differently after a hip fracture or respond differently to exercise?

Details

The impact of gender on functional outcomes after hip fracture was not known. The researchers aimed to determine how gender related to functional outcomes and responses to exercise in older people after hip fracture, and whether any differences persisted after adjusting for cognition, weight and age.

This was a secondary analysis of data from the Enhancing Mobility After Hip Fracture trial, in which older people after hip fracture received either a lower- or higher-intensity exercise program. Functional outcomes included physical performance and self-reported measures. Regression models compared men and women at baseline, week 4 and week 16, with adjustment for baseline values, cognition, weight and age. Interaction terms were used to assess whether the intervention had a different impact by gender.

At baseline, outcome data were available for 160 participants: 30 men (19%) and 130 women (81%). By week 16, 4 men (13%) and 6 women (5%) had withdrawn. There were no gender differences in any baseline measures or in most of the 19 functional outcome measures at weeks 4 and 16.

At week 4, men had better knee extensor strength, with a difference of 2.1 kg (95% confidence interval [CI] 0.6 to 3.7, p < 0.01). This difference did not persist after adjustment for body weight, but did persist after adjustment for baseline values, cognition and age (p = 0.038).

At week 4, men also performed better in coordinated stability, with an error-score difference of -10.0 (95% CI -17.6 to -2.4, p = 0.010). This difference persisted after adjustment for baseline values only, but not after adjustment for cognition and age (p = 0.073).

At week 16, men performed better in coordinated stability, with an error-score difference of -10.2 (95% CI -18.4 to -1.9, p = 0.016). This difference persisted after adjustment only for cognitive impairment (p = 0.029), but not after adjustment for age and baseline values (p = 0.135).

There was no indication that the impact of lower- versus higher-intensity exercise differed by gender. The researchers concluded that a few differences between men and women were observed in strength and balance, but these appeared to be confounded by body weight, age and/or cognition.