Physical Functioning in Patients with a Recent Fracture: The "Can Do, Do Do" Framework Applied to Explore Physical...

Area of Science:

• Geriatrics
• Orthopedics
• Public Health

Background:

• Physical capacity (PC) and physical activity (PA) are crucial for assessing physical performance.
• The "can do, do do" framework combines PC and PA to categorize physical performance.
• Fracture Liaison Services (FLS) manage patients with fractures, often elderly with comorbidities.

Purpose of the Study:

• To explore the physical performance of patients attending a fracture liaison service (FLS).
• To categorize patients into "can do/can't do" and "do do/don't do" physical performance quadrants.
• To assess fall and fracture risk factors across these defined quadrants.

Main Methods:

• A cross-sectional study involving 400 fracture patients (mean age 64, 70.8% female).
• Physical capacity (PC) measured using the 6-minute walking test.
• Physical activity (PA) assessed via accelerometer, defining four performance quadrants.

Main Results:

• 69.5% of patients were "can do, do do", 19.3% "can't do, do do", 8.3% "can't do, don't do", and 3.0% "can do, don't do".
• The "can't do" group had a 9.76 times higher odds ratio for low PA.
• Both "can't do, don't do" and "can't do, do do" groups showed significantly lower physical performance and higher fall/fracture risks compared to "can do, do do".

Conclusions:

• The "can do, do do" framework effectively identifies fracture patients with impaired physical performance.
• Approximately 20% of FLS patients "can't do" but "do do", presenting a high prevalence of fall risk factors.
• This subgroup may be particularly prone to falls, highlighting a need for targeted interventions.