Beit Rivka Geriatric Rehabilitation Center, Petach Tikva, Israel.
Disabil Rehabil. 2012;34(4):304-10. doi: 10.3109/09638288.2011.606346. Epub 2011 Nov 16.
The purpose of this study is to characterize hip-fractured patients who maintained or improved their functional ability, 1 year postdischarge from rehabilitation and to identify factors associated with functional achievement maintenance.
A retrospective study performed in a postacute geriatric rehabilitation center. Two hundred thirty-three hip-fractured patients admitted consecutively from January 2006 to September 2007 were enrolled in the study. The patients were evaluated at discharge from rehabilitation and after 1 year, they were classified into two groups: those who maintained or improved their motor Functional Independence Measure (mFIM) scores and those who deteriorated. The differences between the two patient groups relating to functional, clinical, demographic and fracture-related variables were assessed.
One year postrehabilitation, 130 (55.8%) patients exhibited a decline in their mFIM score. Patients whose 1-year mFIM score had improved were discharged from rehabilitation with a less favorable mean mFIM score (50.7 ± 18.5 vs. 55.6 ± 15.2; p = 0.032), achieved a lower mean mFIM score gain during rehabilitation (12.0 ± 9.7 vs. 14.6 ± 8.1; p = 0.03), had a higher education level (p = 0.003) and had a lower rate of chronic lung disease (p = 0.020) compared with patients whose 1-year mFIM score had deteriorated. After 1 year, only 21 patients (9%) were functionally independent in activities of daily living and only 19 (8.2%) were able to walk unassisted. Only 13 patients (5.6%) perceived that they had regained their former functional level.
A substantial decline in functional ability of hip-fractured patients occurred 1 year postdischarge from rehabilitation. Healthcare providers should be aware of the necessity for a long-term postrehabilitation physical training program to prevent functional decline. Further efforts should be invested in motivating their patients to exercise.
本研究旨在描述从康复出院后 1 年内保持或改善功能能力的髋部骨折患者，并确定与功能维持相关的因素。
这是一项在急性后期老年康复中心进行的回顾性研究。2006 年 1 月至 2007 年 9 月连续收治的 233 例髋部骨折患者纳入本研究。在康复出院时和 1 年后对患者进行评估，将其分为两组：功能改良或维持组和功能恶化组。评估两组患者在功能、临床、人口统计学和骨折相关变量方面的差异。
康复后 1 年，130 例（55.8%）患者的运动功能独立性测量（mFIM）评分下降。1 年 mFIM 评分改善的患者从康复出院时的 mFIM 评分平均值较差（50.7±18.5 比 55.6±15.2；p=0.032），康复期间获得的 mFIM 评分提高平均值较低（12.0±9.7 比 14.6±8.1；p=0.03），教育程度较高（p=0.003），慢性肺部疾病发生率较低（p=0.020）。与 1 年 mFIM 评分恶化的患者相比。1 年后，仅有 21 例（9%）患者在日常生活活动中功能独立，仅有 19 例（8.2%）能够独立行走。只有 13 例（5.6%）患者认为他们恢复了以前的功能水平。
髋部骨折患者从康复出院后 1 年内功能能力显著下降。医疗保健提供者应意识到需要进行长期的康复后体能训练计划，以防止功能下降。应进一步努力激励患者进行锻炼。
