Department of Rehabilitation, the Anti-Tuberculosis Association Shin-Yamanote Hospital.
Department of Physical Therapy, Graduate School of Human Health Science, Tokyo Metropolitan University, Tokyo, Japan.
Int J Rehabil Res. 2023 Sep 1;46(3):270-276. doi: 10.1097/MRR.0000000000000589. Epub 2023 Jun 16.
As the older adult population increases, the number of patients with hip fractures is expected to increase. Hip fractures are a major factor in bedridden patients and decreased activities of daily living. Older adults may have multiple comorbidities, and improving their physical function under comprehensive care is better to meet their needs. Convalescent rehabilitation wards provide comprehensive care and aim to improve the activities of daily living and physical activity in older adults. This study aimed to identify the time of day, including rehabilitation, when physical activities improve in inpatients with subacute postoperative hip fracture, among the many comorbidities of older adults, in comprehensive care, including rehabilitation. This prospective cohort study was conducted in a comprehensive care setting in a subacute rehabilitation ward in a Japanese hospital. Older adult inpatients with a musculoskeletal disease in a subacute rehabilitation ward were divided into the postoperative hip fracture and non-hip fracture patients to examine age, frailty, activities of daily living, and longitudinal physical activity data from objective measures at admission and discharge. Physical activity increased in older adult inpatients with postoperative hip fractures not only during personalized rehabilitation time ( P < 0.001) but also during free activity in the ward ( P < 0.001), despite their tendency to be older, frailer, and lower activities of daily living. In conclusion, postoperative hip fracture inpatients may improve their fitness after receiving comprehensive care.
随着老年人口的增加,髋部骨折患者的数量预计将增加。髋部骨折是导致卧床不起和日常生活活动减少的主要因素。老年人可能患有多种合并症,综合护理下改善他们的身体功能,更好地满足他们的需求。康复病房提供全面护理,旨在改善老年人的日常生活活动和身体活动能力。本研究旨在确定在综合护理下,包括康复治疗,患有多种合并症的亚急性术后髋部骨折住院患者的身体活动在一天中的何时(包括康复治疗时间)改善。这是一项在日本一家医院的亚急性康复病房的综合护理环境中进行的前瞻性队列研究。将亚急性康复病房中的患有肌肉骨骼疾病的老年住院患者分为术后髋部骨折患者和非髋部骨折患者,以检查年龄、虚弱程度、日常生活活动以及从入院和出院时的客观测量中获得的纵向身体活动数据。尽管术后髋部骨折的老年住院患者年龄更大、身体更虚弱、日常生活活动能力更低,但他们的身体活动不仅在个性化康复时间( P < 0.001)期间增加,而且在病房的自由活动期间( P < 0.001)也增加。总之,接受综合护理后,术后髋部骨折的住院患者可能会提高他们的健康水平。