{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:34:10Z","timestamp":1792629250653,"version":"4.5.0"},"reference-count":49,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Falls are a major public health issue, largely driven by age\u2010related declines in hip and lower limb muscle strength. Hip muscle strength plays a critical role in postural stability and falls prevention. Lower balance confidence increases fall risk by restricting activity participation, which may contribute to muscle weakness over time. This study examined the association between hip abductor and flexor strength and the incidence of injurious falls in older adults and investigated whether hip abductor and flexor strength mediate the relationship between balance confidence and incident injurious falls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Participants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009952; aged \u2265\u200965\u2009years) were drawn from the Geelong Osteoporosis Study (GOS). The outcome was the time to first emergency department presentation for an incident injurious fall. Hip abductor and flexor strength were assessed using a handheld dynamometer to measure hip abduction and flexion force, with strength values adjusted for leg lean mass measured by dual\u2010energy X\u2010ray absorptiometry. Balance confidence was assessed using the 14\u2010item Modified Falls Efficacy Scale (MFES). Associations between hip muscle strength and incident injurious falls were evaluated using a competing risk regression model, which accounted for death as a competing event. The results are expressed as adjusted sub\u2010distribution hazard ratios (aSHR) and 95% confidence intervals. Mediation analysis was conducted to assess whether hip abductor and flexor strength mediated the relationship between balance confidence and the incidence of injurious falls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 952 participants, 38% were women (mean age 76.1\u2009\u00b1\u20097.3\u2009years), and 62% were men (mean age 76.9\u2009\u00b1\u20097.0\u2009years). The median follow\u2010up time was 11.5\u2009years (IQR 5.9\u201319.0). During follow\u2010up, 219 participants (23.0%) experienced at least one injurious fall, corresponding to an incidence rate of 19.3 per 1000 person\u2010years (95% CI: 16.9\u201322.0). Greater hip abductor strength was associated with a lower risk of incident injurious falls (aSHR\u2009=\u20090.835, 95% CI: 0.724\u20130.963;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013), with each 1\u2010N\/kg increase in hip abductor strength reducing the sub\u2010distribution hazard by 16.5%. Hip flexor strength was not significantly associated with incident injurious falls. Hip abductor strength accounted for 23.7% of the association between balance confidence and incident injurious falls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Greater hip abductor strength is protective against incident injurious falls in older adults and partially mediates the relationship between balance confidence and injurious falls. Fall prevention strategies should integrate hip abductor strengthening with interventions targeting cognitive and psychological factors, such as improving balance confidence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.70280","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T04:23:14Z","timestamp":1775103794000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Hip Abductor Strength Predicts Injurious Falls and Mediates the Balance Confidence\u2013Falls Relationship: A Competing Risk Model"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3173-6753","authenticated-orcid":false,"given":"Tewodros","family":"Yosef","sequence":"first","affiliation":[{"name":"School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation Deakin University  Geelong Victoria Australia"},{"name":"School of Public Health, College of Medicine and Health Sciences Mizan\u2010Tepi University  Mizan Teferi Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8968-4714","authenticated-orcid":false,"given":"Julie\u00a0A.","family":"Pasco","sequence":"additional","affiliation":[{"name":"School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation Deakin University  Geelong Victoria Australia"},{"name":"Department of Medicine\u2014Western Health The University of Melbourne  St Albans Victoria Australia"},{"name":"Department of Epidemiology and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1210-2437","authenticated-orcid":false,"given":"Monica\u00a0C.","family":"Tembo","sequence":"additional","affiliation":[{"name":"School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation Deakin University  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5064-2990","authenticated-orcid":false,"given":"Kara\u00a0L.","family":"Holloway\u2010Kew","sequence":"additional","affiliation":[{"name":"School of Medicine, IMPACT, The Institute for Mental and Physical Health and Clinical Translation Deakin University  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00391-017-1283-6"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41999-025-01324-7"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/jnr.0000000000000545"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1454117"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.4274\/ejgg.galenos.2023.2023-1-1"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2022.116474"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2020.101627"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2023.02.006"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e24116"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1519\/JSC.0b013e3182a952cc"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00061.2017"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-018-0812-5"},{"issue":"2","key":"e_1_2_11_14_1","first-page":"392","article-title":"Biomarkers of Aging","volume":"2","author":"Vasto S.","year":"2010","journal-title":"Frontiers in Bioscience (Scholar Edition)"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afq034"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afy169"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glu010"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10020343"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP-2019-0144"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.32598\/ptj.10.1.430.1"},{"key":"e_1_2_11_21_1","volume-title":"StatPearls [Internet]","author":"Ardeljan A. 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