Functional risk for fracture by safe functional motion testing: a short version of the safe functional motion test

BACKGROUND: ‘Unsafe’ movement strategies used to perform everyday activities were quantified using scores for tasks included in the Short Form Safe Functional Motion test series (SSFM). Baseline scores were independently associated with incident fractures after adjusting for factors known to effect fracture risk. The purpose of the present study is to determine whether the SSFM, a series of tests of habitual motion, is associated with incident fragility fracture at any skeletal sites. METHODS: An osteoporosis clinic database was queried for adults with baseline SSFM scores and corresponding data for prevalent fractures, femoral neck bone mineral density (fnBMD), osteoporosis medication use, and incident fractures at 1-year and 3-year follow ups [n = 1700 (118 incident fractures) and n = 1058 (202 incident fractures), respectively]. Multiple logistic regressions, adjusted for sex, age, fnBMD, osteoporosis medication use, and any prevalent fractures at baseline, were used to determine whether baseline SSFM scores were associated with incident fragility fractures. RESULTS: An Sfm-3 score was a significant independent predictor of any fracture at 1 year [adjusted odds ratio (95% CI) = 1.118 (1.025, 1.219) for each 10-point decrease in Sfm-3; p = 0.012], and 3-year follow up [adjusted odds ratio (95% CI) = 1.183 (1.098, 1.274) for each 10-point decrease in Sfm-3; p < 0.0001]. CONCLUSIONS: Scores on the SSFM predict fracture risk such that for each 10-point drop in score the odds of fracture are increased by up to 18% independent of risk associated with age, bone mineral density, use of bone-sparing medications, and history of a fracture.