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. 2020 Jul-Aug;36(5):965-970.
doi: 10.12669/pjms.36.5.2412.

Effects of fragility fracture integrated rehabilitation management on mobility, activity of daily living and cognitive functioning in elderly with hip fracture

Affiliations

Effects of fragility fracture integrated rehabilitation management on mobility, activity of daily living and cognitive functioning in elderly with hip fracture

Anam Aftab et al. Pak J Med Sci. 2020 Jul-Aug.

Abstract

Objective: To determine the effectiveness of Fragility Fracture Integrated Rehabilitation Management (FIRM) on mobility, activity of daily living and cognitive functioning in elderly with hip fracture.

Methods: A randomized control trial was conducted at Seoul National University Bundang Hospital, South Korea from August 2017 to January 2018. Patients of both genders with the age 65-95 years, diagnosed cases of hip fracture specifically fractures neck of femur, intertrochanteric, subtrochantric, patients who got bipolar hemiarthroplasty, total hip replacement arthroplasty, reduction and internal fixation were included in this study. A total of n=39 sample was collected through non probability convenience sampling technique and randomly divided into Fragility Integrated Rehabilitation Management (FIRM) group (n=20) and Conventional Physical therapy (CPT) group (n=19). The data was collected through KOVAL for walking ability, modified barthal index (MBI) for behaviors related to activities of daily living (ADLS) and mini mental status examination (MMSE) for cognitive functions at baseline on 2nd postoperative day and after 10th FIRM session on 15th postoperative day.

Results: The mean age of study participants was 82.07±6.00 years. The post intervention comparison did not show any significant difference (p>0.05) in walking ability, overall ADLs and cognitive functioning. But FIRM group showed significant improvement in stair climbing {0(5) ver. 2(7.5), p=0.049} and ambulation or walker use {8(5) ver. 2(4), p=0.037}, as compared to CPT group.

Conclusion: Both groups improved in indoor mobility with walker and crutches as well as activities of daily living. But FIRM showed more improving ambulation with walker and stair climbing. While cognitive functioning was observed only in FIRM group.

Keywords: Activities of Daily Living; Cognition; Hip Fractures; Mobility Limitation; Occupational Therapy; Physical Therapy.

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Figures

Fig.1
Fig.1
CONSORT diagram.
Fig.2
Fig.2
BMI categories of study participants.

References

    1. Bukata SV, Digiovanni BF, Friedman SM, Hoyen H, Kates A, Kates SL, et al. A guide to improving the care of patients with fragility fractures. Geriatr Orthop Surg Rehabil. 2011;2(1):5–37. doi:10.1177/2151458510397504. - PMC - PubMed
    1. Lee SY, Beom J, Kim BR, Lim SK, Lim JY. Comparative effectiveness of fragility fracture integrated rehabilitation management for elderly individuals after hip fracture surgery:A study protocol for a multicenter randomized controlled trial. Medicine (Baltimore) 2018;97(20):e10763. doi:10.1097/MD.0000000000010763. - PMC - PubMed
    1. Bhandari M, Swiontkowski M. Management of Acute Hip Fracture. N Engl J Med. 2017;377(21):2053–2062. doi:10.1056/NEJMcp1611090. - PubMed
    1. Bhandari M, Devereaux PJ, Swiontkowski MF, Tornetta P, Obremskey W, Koval KJ, et al. Internal fixation compared with arthroplasty for displaced fractures of the femoral neck. A meta-analysis. J Bone Joint Surg Am. 2003;85(9):1673–1681. - PubMed
    1. Karlsson A, Berggren M, Gustafson Y, Olofsson B, Lindelof N, Stenvall M. Effects of Geriatric Interdisciplinary Home Rehabilitation on Walking Ability and Length of Hospital Stay After Hip Fracture:A Randomized Controlled Trial. J Am Med Dir Assoc. 2016;17(5):464, e9–464.e15. - PubMed

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