Citation

Hershkovitz A, Beloosesky Y, Brill S. Arch. Gerontol. Geriatr. 2012; 55(1): 35-41.

Affiliation

'Beit Rivka' Geriatric Rehabilitation Center, 4 Hachamisha Street, Petach Tikva 49245, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.archger.2011.06.036

PMID

21871674

Abstract

Our aim was to describe improvement in mobility level in hip fracture patients during a post-acute rehabilitation program and examine variables that may impede mobility improvement. A retrospective chart review of 138 patients with a proximal hip fracture, admitted consecutively during 2006 was conducted. Main outcome measurements were: 6-meter-walking-time (6mWT), rate of improvement (RI) in the 6mWT, gait velocity (GV), functional independence measure (FIM), motor FIM (mFIM) and length of stay (LOS). Most patients (118, 85.5%) showed improvement in the 6mWT (mean 16.05±20.2s, median 12.08). At discharge, 117 patients (84.7%) achieved GV within household ambulation (<0.4m/s). Patients with high initial GV needed shorter rehabilitation time compare to patients with low admission GV (27.5±12.1 days vs. 31.7±12.2 days; p=0.042). The high RI group (≥1s/day) achieved significantly higher admission and discharge FIM scores (70.7±15.9 vs. 64.1±16.9, p=0.023; 87.3±15.8 vs. 79.9±17.4, p=0.013, respectively) and higher admission and discharge mFIM scores (45.3±12.9 vs. 40.8.1±12.7, p=0.049; 60.7±12.4 vs. 56.2±13.4, p=0.045, respectively) compared with the low performance group (<1s/day). Logistic regression analyzed the variables with significant predictive value for achieving high RI (≥1s/day): performance of the 6mWT at FIM≥4 (OR 1.092; 95% CI, 1.056-1.129) and admission FIM score (OR 1.054; 95% CI, 1.023-1.085). Post-acute hip fracture patients capable of bearing weight on their injured leg, with minimal assistance [manual assistance of ≤25% (FIM≥4)] may considerably improve their mobility regardless of their disability, cognitive level or neurological history. Most patients achieved GV enabling them to ambulate short distances within the home.

Language: en