Karlsson Åsa, Berggren Monica, Gustafson Yngve, Olofsson Birgitta, Lindelöf Nina, Stenvall Michael
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
J Am Med Dir Assoc. 2016 May 1;17(5):464.e9-464.e15. doi: 10.1016/j.jamda.2016.02.001. Epub 2016 Mar 11.
To evaluate if Geriatric Interdisciplinary Home Rehabilitation could improve walking ability for older people with hip fracture compared with conventional geriatric care and rehabilitation. A secondary aim was to investigate the postoperative length of hospital stay (LOS).
Randomized controlled trial.
Geriatric ward, ordinary housing, and residential care facilities.
People operated on for a hip fracture (n = 205), aged 70 or older, including those with cognitive impairment, and living in the north of Sweden.
Home rehabilitation with the aim of early hospital discharge that was individually designed and carried out by an interdisciplinary team for a maximum of 10 weeks. Special priority was given to prevention of falls, independence in daily activities, and walking ability both indoors and outdoors.
Walking ability and the use of walking device was assessed in an interview during the hospital stay. These assessments were repeated along with gait speed measurements at 3- and 12-month follow-up. The length of the hospital stay after the hip fracture was recorded.
No significant differences were observed in walking ability, use of walking device, and gait speed at the 3- and 12-month follow-up between the groups. At 12 months, 56.3% of the intervention group and 57.7% of the control group had regained or improved their prefracture walking ability. The median postoperative LOS in the geriatric ward was 6 days shorter for the intervention group (P = .003).
Participants receiving Geriatric Interdisciplinary Home Rehabilitation regained walking ability in the short- and long-term similar to those receiving conventional geriatric care and rehabilitation according to a multifactorial rehabilitation program. The intervention group had a significantly shorter postoperative LOS in the hospital.
评估与传统老年护理和康复相比，老年跨学科家庭康复是否能改善髋部骨折老年人的行走能力。次要目的是调查术后住院时间（LOS）。
随机对照试验。
老年病房、普通住房和寄宿护理机构。
70岁及以上接受髋部骨折手术的患者（n = 205），包括认知障碍患者，居住在瑞典北部。
以早期出院为目标的家庭康复，由跨学科团队进行个性化设计和实施，最长为期10周。特别优先考虑预防跌倒、日常活动的独立性以及室内外行走能力。
在住院期间通过访谈评估行走能力和行走辅助器具的使用情况。在3个月和12个月随访时重复这些评估，并测量步态速度。记录髋部骨折后的住院时间。
两组在3个月和12个月随访时的行走能力、行走辅助器具使用情况和步态速度方面均未观察到显著差异。在12个月时，干预组56.3%的患者和对照组57.7%的患者恢复或改善了骨折前的行走能力。干预组在老年病房的术后中位住院时间短6天（P = .003）。
根据多因素康复计划，接受老年跨学科家庭康复的参与者在短期和长期内恢复行走能力的情况与接受传统老年护理和康复的参与者相似。干预组的术后住院时间明显更短。
