Indian Journal of Physical Medicine and Rehabilitation

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VOLUME 29 , ISSUE 3 ( July-September, 2018 ) > List of Articles

Original Article

Hip Fracture Patients Referred for Rehabilitation After Surgery: Identifying Clinical Predictors for Ambulation

Tan Y Leng

Keywords : Ambulation, Fracture, Rehabilitation

Citation Information : Leng TY. Hip Fracture Patients Referred for Rehabilitation After Surgery: Identifying Clinical Predictors for Ambulation. Indian J Phy Med Rehab 2018; 29 (3):77-82.

DOI: 10.5005/jp-journals-10066-0030

License: CC BY-NC 4.0

Published Online: 01-09-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Background and objectives: Hip fracture patients received rehabilitation in tertiary hospital to maximize recovery after surgery. These patients achieve different ambulation status at the point of discharge. We conducted a prospective study identifying clinical factors affecting ambulation distance achieved and predictors influencing need for walking aid. Materials and methods: One hundred twenty-one hip fracture patients with hip surgery were studied during their course of inpatient rehabilitation in Singapore. Outcome measures at discharge included ambulation distance and patients who needed walking aid at the point of discharge. Results: The mean cohort age was 74.6 ± 9.9 years. Seventy-three (60.3%) were the neck of femur fractures and the rest were intertrochanteric fractures. Eightyseven (72%) had a caregiver. The mean admission functional independence measure (FIM) score was 82 ± 18. Majority (86%, n = 104) did not develop cardiac complications or urinary infection (80%, n = 97) after surgery. The average rehabilitation days were 21 ± 11. The mean ambulation distance was 56.7 ± 54.0 meters. The majority (81%, n = 98) needed walking aid at discharge despite rehabilitation. The positive predictors for better ambulation distance were the absence of renal impairment (B = 25.7, p = 0.022), a higher admission FIM (B = 1.1, p < 0.01) and those who can walk without assistance at discharge(B = 60, p < 0.01). The positive predictors for walking without aid after rehabilitation were those who do not require a caregiver (B = 0.26, p < 0.01), a shorter duration of inpatient rehabilitation (B = 0.01, p = 0.07), and those with more motor FIM gain (B = 0.01, p = 0.028). Conclusion: This hip fracture study highlights the clinical relevance of identifying positive predictors for ambulation status after surgery. Hip fracture rehabilitation units can consider these predictors to assist in devising their rehabilitation programs.

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