Functional recovery after hip fracture: six months' follow-up of patients in a multidisciplinary rehabilitation program
Dai, Y-Tzu.; Huang, G-Shiun.; Yang, R-Sen.; Tsauo, J-Yih.; Yang, L-Hwa.
Journal of the Formosan Medical Association 101(12): 846-853
2002
ISSN/ISBN: 0929-6646 PMID: 12632818 Document Number: 543913
Hip fracture is a major source of disability among the elderly. The purpose of this study was to evaluate the effects of an in-hospital multidisciplinary rehabilitation program (MRP) on basic activities of daily living (BADL) and mobility 6 months after hospital discharge in patients with hip fractures. A before and after quasi-experimental design was used. Subjects were recruited in a large teaching hospital in Taipei, Taiwan. The first 44 consecutive patients recruited received conventional care (control group). The next 50 consecutive patients received physical therapy, nursing-supervised practice of exercise, and discharge planning (intervention group). The 94 patients recruited were aged 60 years or older and were hospitalized to receive open reduction and internal fixation or arthroplasty. Subjects were assessed at admission, on the fourth operative day, on the day of discharge, and 6 months after discharge. On average, subjects did not regain their prefracture functional score for BADL and mobility 6 months after discharge. The intervention versus control group had a lower incidence of functional decline in BADL (16.0% vs. 34.1%; p = 0.01) and mobility (48.0% vs. 75.0%; p = 0.01) 6 months after discharge. Subjects who were independent before fracture (odds ratio [OR], 12.24), did not receive MRP intervention (OR, 4.63), or who were female (OR, 5.24), were more likely to have a decline in function 6 months after discharge. An MRP had a continuous positive effect on hip-fracture patients, thus facilitating improved recovery in BADL and mobility 6 months after discharge.