Independent factors that attenuate the effectiveness of fracture rehabilitation in improving activities of daily living in female patients aged 80 years and above.

BACKGROUND

Some factors, such as cognitive impairment, can attenuate the effectiveness of rehabilitation. We hypothesized that handgrip strength (HGS) might be one of the independent factors affecting the activities of daily living (ADL) improvements in patients with fractures.

AIMS

This study aimed to evaluate the relationship between HGS and improvement in ADL during rehabilitation, and to assess the factors affecting ADL improvement among older patients ≥ 80 years with fractures.

METHODS

This longitudinal study was conducted at a rehabilitation hospital among 427 females aged ≥ 80 years, who underwent fracture rehabilitation. Patients were divided into two groups based on their HGS. Analysis of comparison between the two groups and multivariate linear regression analyses were performed with respect to functional independence measure (FIM) gain during rehabilitation.

RESULTS

FIM gain was significantly lower in the weak HGS group (31.5 [20.0-41.0]) than in the strong HGS group (35.0 [27.5-47.0], p = 0.011). In multivariate linear regression analyses, HGS was significantly associated with FIM gain (coefficient: 0.683, 95% confidence intervals 0.302-1.064, p < 0.001). In addition, Mini-Mental State Examination, necessity of assistance in ADL before injury, length of hospital stays for rehabilitation, and period of rehabilitation per day were significantly associated with FIM gain.

CONCLUSIONS

Weak HGS, cognitive impairment, and necessity of assistance in ADL before injury could be independent factors that attenuate the effectiveness of fracture rehabilitation to improve ADL in old female patients. We encourage such patients to undertake more rehabilitation for improving their ADL, and not refrain from rehabilitation due to old age and fracture.