Article

PURPOSE: Regaining basic mobility after hip fracture surgery is a milestone in
the in-hospital rehabilitation. The aims were to investigate predictors for not
regaining basic mobility at the fifth post-operative day and at discharge after
undergoing hip fracture surgery. METHOD: In a prospective cohort study 274 hip
fracture patients were included. Patients with compromised ability to exercise
were excluded leaving 167 patients for analysis. Patient demographics, functional
level, method of operation, post-operative hemoglobin and the completion of
physiotherapy was registered. Basic mobility was assessed by the Cumulated
Ambulation Score. Multivariate logistic regression was performed. RESULTS: Age
>80 years (OR = 7.5), low prefracture functional level
(OR = 3.0), not completed
the physiotherapy on first post-operative day (OR = 4.6) and hemoglobin <6 mmol/L
measured on first post-operative day (OR = 5.8) were significant predictors of
not regaining basic mobility within the fifth post-operative day (p values: 0.04
- <0.0001). Predictors of not regaining basic mobility at discharge were: Age >80
years (OR = 4.3), prefracture functional level (OR = 7.0) and not completed the
physiotherapy on first post-operative day (OR = 3.3) (p values: 0.009-<0.0001).
CONCLUSIONS: This study shows that patients undergoing hip fracture surgery, who
are not able to complete physiotherapy on first post-operative day, are at a
greater risk of not regaining basic mobility during hospitalization. This
highlights the importance of physiotherapy as part of the interdisciplinary
treatment. IMPLICATIONS FOR REHABILITATION: Regaining abilities in basic mobility
after hip fracture surgery is a primary goal of rehabilitation during
hospitalization in the acute ward. The following factors are indentified to
predict patients not regaining their previous level of basic mobility: Age >80
years, low prefracture functional level, patients not being able to complete the
physiotherapy on the first post-operative day and hemoglobin value <6 mmol/l on
the first post-operative day. In future strategies, the findings regarding both
modifiable and unmodifiable factors, can be used to conduct early planning of
discharge and to take actions in relation to patients who are at a risk of not
regaining basic mobility.

Langue : ANGLAIS