Functional Recovery Following Hip Fracture in the Sub-Acute Setting

Sandy B. Ganz, PT, DSc, GCS
Department of Rehabilitation
Hospital for Special Surgery/Amsterdam Nursing Home
New York, NY

Pam Willams Russo, MD, MPH
Senior Program Officer: Team Leader for Public Health
Robert Wood Johnson Foundation
Princeton, NJ

Andrew Guccione, PT, PhD, FAPTA
Senior Vice President
American Physical Therapy Association
Alexandria, Virginia

Margaret GE. Peterson, PhD

Abstract
Objective:
Measuring functional recovery following hip fracture in the sub-acute setting

Background:  There are over 340,000 hip fractures occur in the United States annually.  Three out of five hospitalizations attributable to injury among persons over 75 were for fractures.  Greater than 50% were hip fractures.

Purpose: The purpose of this study is to describe the functional recovery following hip fracture in the sub acute setting utilizing performance based measures.

Method: This is a prospective observational cohort.

Data Analysis: Descriptive statistics were used for baseline characteristics.  Repeated measures analysis using a Bonferroni correction was utilized to compare admission and discharge performance based measure scores.

Results:  Eighty residents were enrolled in the study, of which seven were withdrawn due to medical complications and 1 subject expired within one week of admission.  Data were analyzed for 72 subjects.  There were 59 females and 13 males ranging in age from 63-99. Mean age was 85.3. The patient profile was as follows:  53% lived alone, 63% were Medicare recipients, 50% used an assistive device prior to hip fracture, 46% sustained a femoral neck fracture, 57% underwent a bipolar hemiarthroplasty, 90% received epidural anesthesia, and 90% had a weight bearing status as weight bearing as tolerated.
Performance Based Measure Results as follows:
Mean test score of the Tinetti Gait and Balance, timed up and go, and six minute walk test.

 

 6MW

TUG
{seconds}

Tinetti
Gait

Tinetti
Balance

Total Tinetti
Gait /Balance

 Admission
(10.2 days)
63.0(88.6) 69.5(43.9) 2.6(2.3) 3.5(3.0) 5.7(4.9)
 Discharge
(32.5 days)
499.2(247.4) 32.8(18.7) 7.2(2.3) 9.9(2.6) 16.8(4.6)
 P value .001* .001* .001* .001* .001*

Key:   6MW= Six minute walk  TUG= Timed Up and Go
                   
Conclusion: There was a significant improvement between admission and discharge timed up and go test, Tinetti gait and balance test and six minute walk test scores in patients who underwent surgical repair of a hip fracture following a fall.

This article appears in HSS Journal: Volume 3, Number 1.
View the full article at springerlink.com.


About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.

 

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