Effectiveness of a multidisciplinary rehabilitation program in elderly patients with hip fractures
Dai, Y.T.; Huang, G.S.; Yang, R.S.; Tsauo, J.Y.; Yang, L.H.
Journal of the Formosan Medical Association 100(2): 120-126
2001
ISSN/ISBN: 0929-6646 PMID: 11393099 Document Number: 532149
Hip fracture is a significant health challenge to the elderly, with a high risk of complications, long hospital stay, and functional deterioration. The purpose of this study was to evaluate the effectiveness of a multidisciplinary rehabilitation program (MRP) in older patients with hip fractures. A before-and-after quasi-experimental design was used. Data were collected at a large teaching hospital in Taipei. The first 105 consecutive patients admitted received conventional care (control group). The next 50 consecutive patients received physical therapy, nurse-supervised exercise, and discharge planning (intervention group). Subjects were assessed upon admission, on the fourth postoperative day, and on the discharge day. The 155 patients recruited met the following criteria: 60 years of age or older, and hospitalized to receive either closed reduction and internal fixation, or hip arthroplasty. Compared with the control group, the intervention group had a shorter average hospital stay (9.9 vs 11.6 days, p = 0.01), earlier ambulation (5.7 vs 6.5 days postoperatively), and a lower rate of bowel incontinence (4.0% vs 23.8%) and pressure sores (14.0% vs 24.8%) during hospitalization. The intervention group experienced less decline in mobility (relative to pre-fracture status) than the control group. No significant difference was found in other outcome variables between the control and intervention groups. The findings of this study indicate that an MRP involving physical therapy, nurse-supervised exercise, and discharge planning positively affects health outcomes in older patients with hip fractures.