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65岁及以上患者髋部骨折手术修复后的成功康复与握力有关,而与直立性低血压无关。

Successful Rehabilitation After Surgical Repair of Hip Fracture Has Been Associated With Handgrip Strength But Not With Orthostatic Hypotension in Patients 65 Yrs of Age and Above.

作者信息

Hilali Abdu El Karim, Shacham David, Frenkel Reut, Abu-Ajaj Ahmed, Zikrin Evgeniya, Freud Tamar, Press Yan

机构信息

From the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (AEKH, DS, RF, AAA, EZ, YP); Department of Geriatrics, Soroka Medical Center, Beer-Sheva, Israel (AEKH, DS, RF, AAA, EZ, YP); Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (TF, YP), Unit for Community Geriatrics, Division of Health in the Community, Ben-Gurion University of the Negev, Beer-Sheva, Israel (YP), and Center for Multidisciplinary Research in Aging, Ben-Gurion University of the Negev, Beer-Sheva, Israel (YP).

出版信息

Am J Phys Med Rehabil. 2025 May 1;104(5):407-414. doi: 10.1097/PHM.0000000000002618. Epub 2024 Aug 26.

Abstract

OBJECTIVE

The identification of factors associated with successful rehabilitation after hip fractures enables more successful planning of the rehabilitation process and discharge from the hospital. Orthostatic hypotension and handgrip strength have been evaluated in previous studies as potential predictors of rehabilitation outcomes, with inconsistent results.

DESIGN

A retrospective study of patients 65 yrs of age and above who underwent rehabilitation after surgical repair of hip fracture in the geriatric department between July 2020 and October 2023. Handgrip strength was measured during the first 3 days of hospitalization using a digital dynamometer. Orthostatic hypotension was measured a week after admission to the ward by the tilt table test. Successful rehabilitation was defined as a Montebello Rehabilitation Factor Score Revised above 50%.

RESULTS

Data were collected for 253 patients. The mean age was 80.5 ± 7.7 and 32.4% were males. The mean handgrip strength was 17.2 ± 6.6 kg. Orthostatic hypotension was diagnosed in 32.8%. One hundred ninety-three patients (76.3%) reached the goal of Montebello Rehabilitation Factor Score Revised ≥ 50 at the end of the rehabilitation. In a logistic regression analysis, handgrip strength, cognitive state, and sex were associated with successful rehabilitation.

CONCLUSIONS

Measuring handgrip strength, but not orthostatic hypotension, can predict successful rehabilitation.

摘要

目的

确定与髋部骨折后成功康复相关的因素,有助于更成功地规划康复过程及安排出院。在以往研究中,直立性低血压和握力已被评估为康复结果的潜在预测指标,但结果并不一致。

设计

一项回顾性研究,研究对象为2020年7月至2023年10月期间在老年科接受髋部骨折手术修复后进行康复治疗的65岁及以上患者。住院前3天使用数字测力计测量握力。入院一周后通过倾斜试验测量直立性低血压。成功康复定义为蒙特贝洛康复因子评分修订版高于50%。

结果

收集了253例患者的数据。平均年龄为80.5±7.7岁,男性占32.4%。平均握力为17.2±6.6千克。直立性低血压的诊断率为32.8%。193例患者(76.3%)在康复结束时达到蒙特贝洛康复因子评分修订版≥50的目标。在逻辑回归分析中,握力、认知状态和性别与成功康复相关。

结论

测量握力而非直立性低血压可预测康复是否成功。

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