One leg standing time predicts fracture risk in older women independent of clinical risk factors and BMD

Review written by Dr Mariana Wingood info

Key Points

  1. One leg standing time (OLST) is an independent predictor of nonvertebral fracture, major osteoporotic fracture, and hip fracture regardless of fracture risk assessment tool score.
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According to the most recent Centers for Disease Control and Prevention report, 16.4% of US older adults had osteoporosis (OP) and 48.4% had low bone mass (1). Furthermore, in 2005, over 2 million fractures were attributed to OP, a number projected to be over 3 million fractures by 2025 (2). Among individuals who sustained an osteoporotic hip fracture, less than 33% return to their prior physical function (3).

Therefore, being able to predict and address an older adult’s risk for fracture is critical. As physical therapists do not always have access to the gold standard assessment for osteoporosis, dual-energy X-ray absorptiometry (DXA), it is important to have clinically feasible and available screening methods for OP and fracture risk.

The aim of this study was to examine the relationship between one leg standing time (OLST) and risk of nonvertebral fracture, major osteoporotic fracture, and hip fracture. It also investigated how OLST contributes to fracture probabilities and the clinical risk factors incorporated within the fracture risk assessment tool (FRAX; see Table 1 for more detail) (4).


16.4% of US older adults have osteoporosis and 48.4% have low bone mass.
A patient’s fracture risk increases as one leg stand time decreases, meaning that the shorter the time a patient is able to stand on one leg, the higher their risk of fracture is.


Study Design: Prospective cohort study

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