Email updates

Keep up to date with the latest news and content from BMC Public Health and BioMed Central.

Open Access Research article

The relationship between physical performance measures, bone mineral density, falls, and the risk of peripheral fracture: a cross-sectional analysis

Hamza Khazzani12, Fadoua Allali123*, Loubna Bennani12, Linda Ichchou12, Laila El Mansouri12, Fatima E Abourazzak12, Redouane Abouqal3 and Najia Hajjaj-Hassouni123

Author Affiliations

1 Department of Rheumatology, El Ayachi hospital, University Hospital of Rabat-Sale, Sale, Morocco

2 Laboratory of Information and Research on Bone Diseases (LIRPOS), Faculty of Medicine and Pharmacy, Rabat, Morocco

3 Laboratory of Biostatistics, Clinical Research and Epidemiology (LBRCE), Faculty of Medicine and Pharmacy, Rabat, Morocco

For all author emails, please log on.

BMC Public Health 2009, 9:297  doi:10.1186/1471-2458-9-297

Published: 18 August 2009



Several factors, in addition to low bone mineral density (BMD), have been identified as risks for fractures, including reduced levels of physical activity, poor balance and low physical performance. The aim of this study was to evaluate the relationship between physical performance measures, BMD, falls, and the risk of peripheral fracture in a population sample of Moroccan women.


484 healthy women were included. Three measures were used to assess physical performance: timed get-up-and-go test 'TGUGT', five-times-sit-to-stand test '5 TSTS' and 8-feet timed walk '8 FTW'. The association between physical performance measures and BMD, peripheral fracture and falls was performed by univariate and multivariate analysis.


The mean age was 55.1 years. Higher 'TGUGT', '5 TSTS', '8 FTW' test scores were associated with lower BMD measured at different sites (p range from < 0.001 to 0.005). The relationship between the three tests and BMD in all measured sites remained significant after multiple linear regression (p range from <0.001 to 0.026). In the group of post-menopausal patients, the scores of 'TGUGT' and '8 FTW' were significantly higher in fractured patients compared with patients without. After logistic regression, a score of 'TGUGT' > 14.2 sec, a score of '5 TSTS' > 12.9 sec and a score of '8 FTW' > 4.6 sec respectively, increased the probability of anterior peripheral fracture by 2.7, 2.2 and 2.3 (OR = 2.7; 95% CI = 1.2–6.4, OR = 2.2; 95% CI = 1.1–5.2; and OR = 2.3; 95% CI = 1.1–5.1). There was a significant positive correlation between the number of fall/year and the 3 tests. This correlation persisted after poisson regression.


This study suggested that low physical performance is associated with low BMD, and a high risk of history of falls and fractures.