{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:31:10Z","timestamp":1787754670307,"version":"build-2784847793"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2016,7,20]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The physical risk factors leading to distal radial fractures are poorly understood. The goal of this study was to compare postural stability between older adults with and without a prior distal radial fragility fracture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This case-control evaluation was performed at a single tertiary institution. The fracture cohort comprised 23 patients treated for a low-energy distal radial fracture within 6 to 24 months prior to this study. Twenty-three age and sex-matched control participants, without a prior fragility fracture, were selected from an outpatient clinic population. All participants completed a balance assessment with a computerized balance platform device. Dynamic motion analysis (DMA) scores ranging from 0 to 1,440 points are produced, with lower scores indicating better postural stability. Participants also completed validated questionnaires for general health quality (EuroQol-5D-3L [EQ-5D-3L]) and physical activity (Physical Activity Scale for the Elderly [PASE]) and comprehensive health and demographic information including treatment for compromised balance or osteoporosis. Statistical analysis compared data between cases and controls using either the Student t test or the Mann-Whitney U test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>There were no significant differences (p &gt; 0.05) in age, sex, body mass index, physical activity score, or EQ-5D-3L general health visual analog scale score between participants with or without prior distal radial fracture. The fracture cohort demonstrated poorer balance, with higher DMA scores at 933 points compared with 790 points for the control cohort (p = 0.008). Nineteen patients (83%) in the fracture cohort reported having dual x-ray absorptiometry (DXA) scans within 5 years prior to this study, but only 2 patients (9%) had ever been referred for balance training with physical therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Older adults who sustain low-energy distal radial fractures demonstrate impaired postural stability compared with individuals of a similar age who have not sustained such fractures. Following a distal radial fracture, these patients may benefit from interventions to improve postural stability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.15.00963","type":"journal-article","created":{"date-parts":[[2016,7,20]],"date-time":"2016-07-20T14:13:02Z","timestamp":1469023982000},"page":"1176-1182","source":"Crossref","is-referenced-by-count":28,"title":["Postural Stability in Older Adults with a Distal Radial Fracture"],"prefix":"10.2106","volume":"98","author":[{"given":"Craig R.","family":"Louer","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean L.","family":"Boone","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre K.","family":"Guthrie","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R.","family":"Motley","sequence":"additional","affiliation":[{"name":"Sports Therapy and Rehabilitation Center, Barnes-Jewish West County Hospital, Chesterfield, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan P.","family":"Calfee","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindley B.","family":"Wall","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"5","key":"bib1-20230714","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1053\/jhsu.2001.26322","article-title":"The frequency and epidemiology of hand and forearm fractures in the United States","volume":"26","author":"Chung","year":"2001","journal-title":"J Hand Surg Am."},{"issue":"6","key":"bib2-20230714","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1093\/aje\/153.6.587","article-title":"Risk factors for proximal humerus, forearm, and wrist fractures in elderly men and women: the Dubbo Osteoporosis Epidemiology Study","volume":"153","author":"Nguyen","year":"2001","journal-title":"Am J Epidemiol."},{"issue":"3","key":"bib3-20230714","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s00198-002-1364-1","article-title":"Risk factors for Colles\u2019 fracture in men and women: results from the European Prospective Osteoporosis Study","volume":"14","author":"Silman","year":"2003","journal-title":"Osteoporos Int."},{"issue":"6","key":"bib4-20230714","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1007\/s00198-004-1745-8","article-title":"Reducing the risk for distal forearm fracture: preserve bone mass, slow down, and don\u2019t fall!","volume":"16","author":"Kelsey","year":"2005","journal-title":"Osteoporos Int."},{"issue":"20","key":"bib5-20230714","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.2106\/JBJS.O.00313","article-title":"25-hydroxyvitamin-D and bone turnover marker levels in patients with distal radial fracture","volume":"97","author":"Rozental","year":"2015","journal-title":"J Bone Joint Surg Am."},{"issue":"6","key":"bib6-20230714","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1007\/BF01629573","article-title":"Different risk profiles for hip fractures and distal forearm fractures: a prospective study","volume":"6","author":"Graafmans","year":"1996","journal-title":"Osteoporos Int."},{"issue":"5","key":"bib7-20230714","doi-asserted-by":"crossref","first-page":"e42","DOI":"10.2106\/JBJS.M.01456","article-title":"Physical fitness and orthopaedic health: clues that your intuition is right: commentary on an article by Young Jae Cho, MD, et al.: \u201cEvaluation of physical performance level as a fall risk factor in women with a distal radial fracture\u201d","volume":"96","author":"Benson","year":"2014","journal-title":"J Bone Joint Surg Am."},{"issue":"5","key":"bib8-20230714","doi-asserted-by":"crossref","first-page":"361","DOI":"10.2106\/JBJS.L.01359","article-title":"Evaluation of physical performance level as a fall risk factor in women with a distal radial fracture","volume":"96","author":"Cho","year":"2014","journal-title":"J Bone Joint Surg Am."},{"issue":"6","key":"bib9-20230714","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1007\/BF01622186","article-title":"Risk factors for fractures of the distal forearm: a population-based case-control study","volume":"4","author":"Mallmin","year":"1994","journal-title":"Osteoporos Int."},{"issue":"3","key":"bib10-20230714","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1136\/jech.50.3.288","article-title":"Risk factors, falls, and fracture of the distal forearm in Manchester, UK","volume":"50","author":"O\u2019Neill","year":"1996","journal-title":"J Epidemiol Community Health."},{"issue":"4","key":"bib11-20230714","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1111\/j.1447-0594.2012.00856.x","article-title":"Testing postural control among various osteoporotic patient groups: a literature review","volume":"12","author":"de Groot","year":"2012","journal-title":"Geriatr Gerontol Int."},{"issue":"3","key":"bib12-20230714","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/S0966-6362(01)00142-4","article-title":"Differential diagnosis of proprioceptive and vestibular deficits using dynamic support-surface posturography","volume":"14","author":"Allum","year":"2001","journal-title":"Gait Posture."},{"issue":"1","key":"bib13-20230714","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.apmr.2008.06.025","article-title":"A comparison of balance performance: computerized dynamic posturography and a random motion platform","volume":"90","author":"Broglio","year":"2009","journal-title":"Arch Phys Med Rehabil."},{"key":"bib14-20230714","doi-asserted-by":"crossref","first-page":"S154","DOI":"10.1249\/01.mss.0000273561.33668.a4","article-title":"Proprio 5000: a new method for assessing dynamic balance","volume":"39","author":"Charnock","year":"2007","journal-title":"Med Sci Sports Exerc."},{"issue":"3","key":"bib15-20230714","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/0168-8510(90)90421-9","article-title":"EuroQol\u2014a new facility for the measurement of health-related quality of life","volume":"16","year":"1990","journal-title":"Health Policy."},{"issue":"2","key":"bib16-20230714","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/0895-4356(93)90053-4","article-title":"The Physical Activity Scale for the Elderly (PASE): development and evaluation","volume":"46","author":"Washburn","year":"1993","journal-title":"J Clin Epidemiol."},{"issue":"2","key":"bib17-20230714","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1007\/s11999-013-3082-8","article-title":"Hip resurfacing does not improve proprioception compared with THA","volume":"472","author":"Larkin","year":"2014","journal-title":"Clin Orthop Relat Res."},{"issue":"5","key":"bib18-20230714","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1097\/01.MLR.0000062554.74615.4C","article-title":"Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation","volume":"41","author":"Norman","year":"2003","journal-title":"Med Care."},{"issue":"2","key":"bib19-20230714","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1111\/j.1365-2125.2005.02543.x","article-title":"Polypharmacy and falls in the middle age and elderly population","volume":"61","author":"Ziere","year":"2006","journal-title":"Br J Clin Pharmacol."},{"issue":"5","key":"bib20-20230714","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1111\/j.1532-5415.2011.03386.x","article-title":"Associations between drug burden index and falls in older people in residential aged care","volume":"59","author":"Wilson","year":"2011","journal-title":"J Am Geriatr Soc."},{"issue":"5","key":"bib21-20230714","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1136\/ip.2005.011015","article-title":"The costs of fatal and non-fatal falls among older adults","volume":"12","author":"Stevens","year":"2006","journal-title":"Inj Prev."},{"issue":"1","key":"bib22-20230714","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1056\/NEJMcp020719","article-title":"Clinical practice. Preventing falls in elderly persons","volume":"348","author":"Tinetti","year":"2003","journal-title":"N Engl J Med."},{"issue":"4","key":"bib23-20230714","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/BF00296650","article-title":"Fracture of the distal forearm as a forecaster of subsequent hip fracture: a population-based cohort study with 24 years of follow-up","volume":"52","author":"Mallmin","year":"1993","journal-title":"Calcif Tissue Int."},{"issue":"2","key":"bib24-20230714","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1080\/17453670710013799","article-title":"Are distal radius fractures due to fragility or to falls? A consecutive case-control study of bone mineral density, tendency to fall, risk factors for osteoporosis, and health-related quality of life","volume":"78","author":"Nordvall","year":"2007","journal-title":"Acta Orthop."},{"issue":"12","key":"bib25-20230714","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1056\/NEJM199503233321202","article-title":"Risk factors for hip fracture in white women","volume":"332","author":"Cummings","year":"1995","journal-title":"N Engl J Med."},{"issue":"5","key":"bib26-20230714","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1001\/jama.2009.50","article-title":"Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women","volume":"301","author":"Bliuc","year":"2009","journal-title":"JAMA."},{"key":"bib27-20230714","first-page":"CD007146","article-title":"Interventions for preventing falls in older people living in the community","volume":"9","author":"Gillespie","year":"2012","journal-title":"Cochrane Database Syst Rev."},{"issue":"1","key":"bib28-20230714","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1111\/j.1532-5415.2010.03234.x","article-title":"Summary of the updated American Geriatrics Society\/British Geriatrics Society clinical practice guideline for prevention of falls in older persons","volume":"59","year":"2011","journal-title":"J Am Geriatr Soc."},{"issue":"5","key":"bib29-20230714","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1111\/j.1532-5415.1996.tb01432.x","article-title":"Reducing frailty and falls in older persons: an investigation of tai chi and computerized balance training. Atlanta FICSIT Group. Frailty and Injuries: Cooperative Studies of Intervention Techniques","volume":"44","author":"Wolf","year":"1996","journal-title":"J Am Geriatr Soc."},{"issue":"4","key":"bib30-20230714","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1097\/00002060-200204000-00001","article-title":"Reducing the risk of falls through proprioceptive dynamic posture training in osteoporotic women with kyphotic posturing: a randomized pilot study","volume":"81","author":"Sinaki","year":"2002","journal-title":"Am J Phys Med Rehabil."},{"issue":"5","key":"bib32-20230714","doi-asserted-by":"crossref","first-page":"953","DOI":"10.2106\/JBJS.G.01121","article-title":"Improving evaluation and treatment for osteoporosis following distal radial fractures. A prospective randomized intervention","volume":"90","author":"Rozental","year":"2008","journal-title":"J Bone Joint Surg Am."},{"issue":"4","key":"bib33-20230714","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1001\/archinte.162.4.421","article-title":"Osteoporosis intervention following distal forearm fractures: a missed opportunity?","volume":"162","author":"Cuddihy","year":"2002","journal-title":"Arch Intern Med."},{"issue":"5","key":"bib34-20230714","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1007\/s00774-006-0704-1","article-title":"Clinical factors as predictors of the risk of falls and subsequent bone fractures due to osteoporosis in postmenopausal women","volume":"24","author":"Komatsu","year":"2006","journal-title":"J Bone Miner Metab."},{"key":"bib35-20230714","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1186\/1471-2458-9-297","article-title":"The relationship between physical performance measures, bone mineral density, falls, and the risk of peripheral fracture: a cross-sectional analysis","volume":"9","author":"Khazzani","year":"2009","journal-title":"BMC Public Health."},{"issue":"4","key":"bib36-20230714","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/s00198-006-0277-9","article-title":"Balance impairment is related to vertebral fracture rather than thoracic kyphosis in individuals with osteoporosis","volume":"18","author":"Greig","year":"2007","journal-title":"Osteoporos Int."},{"issue":"4","key":"bib37-20230714","doi-asserted-by":"crossref","first-page":"M123","DOI":"10.1093\/geronj\/46.4.M123","article-title":"Fear of falling and postural performance in the elderly","volume":"46","author":"Maki","year":"1991","journal-title":"J Gerontol."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201607200-00005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:30:46Z","timestamp":1787751046000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201607200-00005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,20]]},"references-count":36,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2016]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.15.00963","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,20]]}}}