Ariza-Vega Patrocinio, Jiménez-Moleón José Juan, Kristensen Morten Tange
Rehabilitation and Traumatology Service, Virgen de las Nieves Hospital , Granada , Spain .
Disabil Rehabil. 2014;36(8):685-90. doi: 10.3109/09638288.2013.813081. Epub 2013 Aug 6.
To study the recovery of patients in terms of 18 activities of daily living and change of residence within the year following a hip fracture.
This prospective cohort study was carried out in a trauma service of an acute hospital in southern Spain including 159 patients with a hip fracture, 65 years or older and allowed weight-bearing after surgery. Patients or their relatives were interviewed about their residential status and functional level at pre-fracture, three months and one year after surgery, using the Functional Independence Measure.
Losses of function for the main activities affected were, at the first month, third month and one year relative to the pre-fracture status, 50%, 25% and 12%, respectively, for locomotion, 40%, 25% and 20%, respectively, for mobility and 27%, 17% and 15%, respectively, for self care (p < 0.001). Residential status changed mostly for patients who lived in their own home (73% before fracture to 58% at one year).
The loss of independence in the first year after a hip fracture is substantial for specific activities. Recovery mainly takes place during the first three months after surgery. Change of residence mostly involved those patients who lived alone in their own home at pre-fracture. Implications for Rehabilitation One year after fracture, patients did not recover their previous function, and the activities most affected at the one-year follow-up were: dressing lower body, bathing/showering, transfer bathtub/shower and walking up/down stairs. After a hip fracture, most recovery of the function happens within the first three months, though some functional activities continue recovering over the first year. Rehabilitation programs cannot be based only on mobility activities, the recovery of other daily living activities should also be included.
研究髋部骨折患者在日常生活的18项活动方面的恢复情况以及骨折后一年内的居住状况变化。
这项前瞻性队列研究在西班牙南部一家急症医院的创伤科进行，纳入了159例65岁及以上且术后允许负重的髋部骨折患者。使用功能独立性测量量表，就患者或其亲属在骨折前、术后三个月和一年时的居住状况和功能水平进行访谈。
相对于骨折前状态，主要受影响活动的功能丧失情况为：第一个月、第三个月和一年时，移动方面分别为50%、25%和12%，活动能力方面分别为40%、25%和20%，自我护理方面分别为27%、17%和15%（p<0.001）。居住状况变化最大的是那些术前住在自己家中的患者（骨折前为73%，一年时为58%）。
髋部骨折后第一年，特定活动的独立性丧失相当严重。恢复主要发生在术后的前三个月。居住状况的改变主要涉及那些骨折前独自居住在自己家中的患者。康复意义骨折一年后，患者未恢复到之前的功能水平，在一年随访中受影响最大的活动是：下半身穿衣、洗澡/淋浴、进出浴缸/淋浴间以及上下楼梯。髋部骨折后，大部分功能恢复发生在前三个月，不过一些功能活动在第一年仍持续恢复。康复计划不能仅基于移动活动，还应包括其他日常生活活动的恢复。
