Physical therapy and mobility 2 and 6 months after hip fracture

被引:56
|
作者
Penrod, JD
Boockvar, KS
Litke, A
Magaziner, J
Hannan, EL
Halm, EA
Silberzweig, SB
Sean Morrison, R
Orosz, GM
Koval, KJ
Siu, AL
机构
[1] Bronx Vet Affairs Med Ctr, Program Res Serious Phys & Mental Illness, New York, NY USA
[2] Bronx Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, New York, NY USA
[3] Mt Sinai Sch Med, Dept Geriatr & Adult Dev, New York, NY USA
[4] Univ Maryland, Sch Med, Dept Epidemiol & Prevent Med, Baltimore, MD 21201 USA
[5] SUNY Albany, Sch Publ Hlth, Dept Hlth Policy Management & Behav, Rensselaer, NY USA
[6] NYU, Sch Med, Dept Orthoped Surg, New York, NY USA
关键词
hip fractures; physical therapy; mobility; disability;
D O I
10.1111/j.1532-5415.2004.52309.x
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
OBJECTIVES: To examine the relationship between early physical therapy (PT), later therapy, and mobility 2 and 6 months after hip fracture. DESIGN: Prospective, multisite observational study. SETTING: Four hospitals in the New York City area. PARTICIPANTS: Four hundred forty-three hospitalized older patients discharged after surgery for hip fracture in 1997-98. MEASUREMENTS: Patient demographics, fracture type, comorbidities, dementia, number of new impairments at discharge, amount of PT between day of surgery and postoperative day (POD) 3, amount of therapy between POD4 and 8 weeks later, and prefracture, 2-, and 6-month mobility measured using the Functional Independence Measure. RESULTS: More PT immediately after hip fracture surgery was associated with significantly better locomotion 2 months later. Each additional session from the day of surgery through POD3 was associated with an increase of 0.4 points (P=.032) on the 14-point locomotion scale, but the positive relationship between early PT and mobility was attenuated by 6 months postfracture. There was no association between later therapy and 2- or 6-month mobility. CONCLUSION: PT immediately after hip fracture surgery is beneficial. The effects of later therapy on mobility were difficult to assess because of limitations of the data. Well-designed randomized, controlled trials of the effect of varying schedules and amounts of therapy on functional status after hip fracture would be informative.
引用
收藏
页码:1114 / 1120
页数:7
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