Itagaki Atsunori, Kakizaki Ayaka, Funahashi Miyuki, Sato Kaori, Yasuhara Kyoko, Ishikawa Akira
Department of Cardiac Rehabilitation, The Cardiovascular Institute: 3-2-19 Nishiazabu, Minato-ku, Tokyo, Japan.
Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Japan.
J Phys Ther Sci. 2019 Mar;31(3):277-281. doi: 10.1589/jpts.31.277. Epub 2019 Mar 19.
[Purpose] Heart failure has been identified as a risk factor for reduced physical function and falls; however, the impact of heart failure on functional recovery after a hip fracture is unclear. This study aimed to examine how heart failure and pre-fracture physical function affect recovery after a hip fracture. [Participants and Methods] The study population consisted of 122 patients with sub-acute hip fracture (mean age 81.7 ± 9.7 years, 18.9% male) who were divided into two groups: heart failure and non-heart failure. The outcome measurement was the functional independence measure effectiveness. A two-way analysis of variance was performed to investigate how heart failure and ambulatory ability prior to hip fracture were related to the functional independence measure effectiveness. [Results] Seventeen patients (13.9%) had a history of heart failure. The two-way analysis of variance showed the two independent variables (heart failure and ambulatory ability before fracture) had significant main effects; however, their interaction effect was not significant. [Conclusion] Heart failure affects functional recovery after hip fracture independent of the pre-fracture physical function, and vice versa. Further research on rehabilitation in hip fracture patients with heart failure is required to develop strategies to overcome poor functional recovery in such patients.
[目的] 心力衰竭已被确定为身体功能下降和跌倒的危险因素；然而，心力衰竭对髋部骨折后功能恢复的影响尚不清楚。本研究旨在探讨心力衰竭和骨折前身体功能如何影响髋部骨折后的恢复。[参与者与方法] 研究人群包括122例亚急性髋部骨折患者（平均年龄81.7±9.7岁，男性占18.9%），分为两组：心力衰竭组和非心力衰竭组。结局指标为功能独立性测量有效性。进行双向方差分析，以研究心力衰竭和髋部骨折前的行走能力如何与功能独立性测量有效性相关。[结果] 17例患者（13.9%）有心力衰竭病史。双向方差分析显示，两个自变量（心力衰竭和骨折前行走能力）有显著的主效应；然而，它们的交互效应不显著。[结论] 心力衰竭独立于骨折前身体功能影响髋部骨折后的功能恢复，反之亦然。需要对心力衰竭髋部骨折患者的康复进行进一步研究，以制定策略克服此类患者功能恢复不良的问题。
