Article

OBJECTIVE: To examine whether functional performance upon hospital discharge is
influenced by pain in the region of the hip fracture or related to the fracture
type. DESIGN: Prospective observational study. SETTING: A 20-bed orthopedic hip
fracture unit. PATIENTS: Fifty-five cognitively intact patients (20 men and 35
women; ages 75.8 +/- 10 years), 33 with a cervical hip fracture and 22 with an
intertrochanteric hip fracture, all of whom were allowed to bear full weight
after surgery. METHODS: All patients were evaluated upon discharge from the
hospital to their own homes at a mean of 10 +/- 6 days after surgery. MAIN
OUTCOME MEASUREMENTS: The Timed Up & Go (TUG) test, supervised by a physical
therapist, was used to evaluate functional performance, and a 5-point verbal
ranking scale (0 = no pain to 4 = intolerable pain) was used to evaluate pain.
RESULTS: Patients took an average of 22.7 +/- 11.7 seconds to perform the TUG. No
significant differences were observed in baseline characteristics or pain
medication given for patients with a cervical versus an intertrochanteric
fracture (P >/= .22), but patients with an intertrochanteric fracture presented
more often with moderate to severe pain during testing (P < .001), with
associated poorer performances on the TUG test (29.4 +/- 12.8 seconds versus 18.3
+/- 8.5 seconds). Univariate analysis showed that TUG scores were associated with
age, prefracture function evaluated by the New Mobility Score, fracture type, day
of TUG performance, and pain intensity. Multivariate linear regression analyses
(fracture type not included) showed that only greater age (B = 0.34), low
prefracture function (B = 7.9), and experiencing moderate to severe pain (B =
8.7) were independently associated with having a poorer TUG score. CONCLUSIONS:
Hip fracture-related pain primarily compromises the functional performance of
patients with an intertrochanteric hip fracture upon discharge from hospital.
Physical therapists should be involved in new and optimized fracture-type
stratified pain management strategies.
CI - Copyright (c) 2013 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS