Department of Physical Therapy, Arcadia University, Glenside, PA, USA.
College of Health Sciences, Department of Physical Therapy, Arcadia University, Glenside, PA, USA.
J Gerontol A Biol Sci Med Sci. 2021 Oct 13;76(11):e335-e339. doi: 10.1093/gerona/glab044.
The impact of frailty on walking recovery after hip fracture has not been reported. We describe the prevalence of frailty approximately 3 months after hip fracture, and identify the impact of baseline frailty on ambulation recovery.
Data from the Community Ambulation Project, that examined the effects of 2 multicomponent home exercise programs on 6-minute walk test in participants post hip fracture, were used to reconstruct the 5-item frailty phenotype. We detailed the prevalence of frailty by subgroup and assessed the comparability between frailty groups for the categorical variable of achieving 300 m in 6-minute walk test (community ambulation threshold), and the continuous variable of total distance in 6-minute walk test before and after 16 weeks of intervention.
Of the 210 participants, 9% were nonfrail, 59% were prefrail, and 32% were frail. The odds of a nonfrail participant achieving the 300-m threshold were 14.4 (95% CI: 2.4-87.6) times the odds of a frail participant, while a prefrail participant's odds were 6.1 (95% CI: 1.3-28.4) times after controlling for treatment group and baseline walking distance. The nonfrail participants had an increase of 92.1 m from baseline to 16 weeks, the prefrail had a 50.8 m increase, and the frail group had the smallest increase of 36.6 m (p < .001 for all).
Prefrailty and frailty were highly prevalent in this sample of community-dwelling survivors of a recent hip fracture. Gains in walking distance and attaining a level of community ambulation were affected significantly by the level of baseline frailty.
衰弱对髋部骨折后行走恢复的影响尚未报道。我们描述了髋部骨折后大约 3 个月时衰弱的患病率，并确定了基线衰弱对步行恢复的影响。
使用社区步行能力计划的数据，该计划检查了 2 种多成分家庭运动方案对髋部骨折后参与者 6 分钟步行测试的影响，来重建 5 项衰弱表型。我们按亚组详细描述衰弱的患病率，并评估在达到 6 分钟步行测试 300m（社区步行能力阈）的分类变量和干预前、后 6 分钟步行测试总距离的连续变量方面，衰弱组之间的可比性。
在 210 名参与者中，9%是非衰弱的，59%是衰弱前期的，32%是衰弱的。非衰弱参与者达到 300m 阈的几率是非衰弱参与者的 14.4 倍（95%CI：2.4-87.6），而衰弱前期参与者的几率是衰弱参与者的 6.1 倍（95%CI：1.3-28.4），调整了治疗组和基线行走距离。非衰弱参与者从基线到 16 周的距离增加了 92.1m，衰弱前期增加了 50.8m，而衰弱组的增加最小，为 36.6m（所有均<.001）。
在最近髋部骨折的社区幸存者中，衰弱前期和衰弱是非常普遍的。行走距离的增加和达到社区步行能力的水平显著受到基线衰弱程度的影响。
