Prediction functional independence measure in HIP fracture patients

2013 ◽  
Author(s):  
Aleksandar Jeremic ◽  
Natasa Radosavljevic ◽  
Dejan Nikolic ◽  
Milica Lazovic
Keyword(s):  
Hip Fracture ◽  
Functional Independence Measure ◽  
Functional Independence

scholarly journals Evaluation of Functional Recovery by Motor Functional Independence Measure Test of Elderly After Hip Fracture in Serbia

2014 ◽  
Vol 27 (1) ◽  
pp. 88 ◽  
Author(s):  
Natasa Radosavljevic ◽  
Dejan Nikolic ◽  
Milica Lazovic ◽  
Zoran Radosavljevic ◽  
Aleksandar Jeremic
Keyword(s):  
Hip Fracture ◽  
Functional Recovery ◽  
Age Groups ◽  
Functional Independence Measure ◽  
Severity Index ◽  
Functional Independence ◽  
Post Discharge ◽  
Third Age ◽  
Period 2 ◽  
Group 2

<p class="p0" style="margin-bottom: 0pt; margin-top: 0pt; text-align: justify; line-height: 200%;"><span style="mso-spacerun: 'yes'; font-size: 12.0000pt; font-family: 'Times New Roman'; background: #ffffff; mso-shading: #ffffff;"><strong>Introduction:</strong> The aim of the study was to evaluate motor functional status measured by motor Functional Independence Measure (mFIM) test in population above 65 years of age after the hip fracture.<br /><strong>Material and Methods:</strong> We evaluated 203 patients after hip fracture by mFIM test on 3 occasions: at admission (Period-1), at discharge (Period-2) and 3 months after discharge (Period-3); 3 age groups: Group65-74, Group75-84 and Group85-up and 2 groups concerning Severity Index (SI): group 0-1.99 (SI1) and group ≥ 2 (SI2).<br /><strong>Results:</strong> In same SI group there is significant increase in mFIM values for Period-2 and Period-3 for both genders and in first two age groups, while for those above 85 years of age with higher SI we found non-significant change in mFIM values between discharge and 3 months post discharge period.<br /><strong>Discussion: </strong>The most significant improvement is obtained for women in first and third age groups and with higher SI.<br /><strong>Conclusion:</strong> Gender is not significant predictor for motor functional recovery measured by mFIM test in patients with hip fracture, although the admittance mFIM is a good indicator for mFIM capacity recovery in women of certain age groups (first and third age groups).</span></p>

scholarly journals Inpatient Rehabilitation after Hip Fracture: Predicting Success in Rehabilitation based on Preliminary FIM

2021 ◽  
Vol 8 (1) ◽  
pp. 01-05
Author(s):  
Jochanan Naschitz
Keyword(s):  
Hip Fracture ◽  
Multidisciplinary Team ◽  
Comprehensive Evaluation ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Rehabilitation Center ◽  
Predicting Success ◽  
The Mean ◽  
Surrogate Measure

Background: Predicting success of inpatient rehabilitation after hip fracture is an unmet challenge Objective: To assess whether a first impression Functional Independence Measure (FIM) before comprehensive evaluation may be useful to predict success in rehabilitation Setting: Geriatric rehabilitation center. Design: Retrospective observational study Subjects: 42 consecutive elderly patients with proximal hip fracture. Methods: The Functional Independence Measure (FIM) was assessed on the day of admission by a nurse (PreFIM), on day 3-5 by a multidisciplinary team (FimAdm) and on the day before discharge by the same multidisciplinary team (FIMDis). The potential of motor PreFIM to predict rehabilitation success, corresponding to motor FIMDis >58, was assessed, along with the length of stay in rehabilitation (LOS). Results: The mean motor PreFIM was 43.3 (SD 11.4), motor FIMAdm 48.9 (SD 13.7), motor FIMDis 63.8 (SD 16.7), LOS 22.5 days (SD 9.7). Motor PreFIM predicted motor FIM discharge >58, the surrogate measure for success of rehabilitation, with 76.7% sensitivity and 83.3% specificity. Motor PreFIM relation to LOS was statistically insignificant. Conclusions: In a population of disabled elderlies, the motor PreFIM on admission-day was helpful to predict success in rehabilitation after hip fracture, but not the necessary duration of rehabilitation. Large prospective studies are needed to validate this data.

scholarly journals Correlation of cardiovascular and respiratory comorbidities with motor functional independence in the elderly after hip fracture

2021 ◽  
Vol 74 (1-2) ◽  
pp. 20-24
Author(s):  
Natasa Radosavljevic ◽  
Dejan Nikolic ◽  
Sofija Radosavljevic ◽  
Mirko Grajic ◽  
Ksenija Boskovic
Keyword(s):  
Hip Fracture ◽  
Rating Scale ◽  
Functional Independence Measure ◽  
Severity Index ◽  
The Elderly ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Significant Difference ◽  
Different Levels

Introduction. The aim of the study was to evaluate the correlation between different levels of examined comorbidities using the Cumulative Illness Rating Scale for Geriatrics and motor Functional Independence Measure test in the elderly after hip fracture. Material and Methods. The study included 203 geriatric patients, 65 years of age and older, who were referred to a rehabilitation program at the Institute for Rehabilitation after hip fracture. The following comorbidities were analyzed: cardiac, vascular, and respiratory. The motor component of Functional Independence Measure was used to assess functional recovery. The Cumulative Illness Rating Scale for Geriatrics was used to calculate the comorbidity index. The patients were assessed on 4 different occasions: on admission, on discharge, 3 months after discharge, and 6 months after discharge. The short-term and long-term efficiency of rehabilitation treatment was measured. Results. There is a significant difference in motor Functional Independence Measure scores between different levels of vascular (p = 0.010) and respiratory (p = 0.047) comorbidities only on admission, while at other times of observation no significant difference (p > 0.05) was found. The highest level of correlation was found in level 3 comorbidity severity index for cardiac comorbidity (discharge/3 months) (Pearson?s correlation - R = 0.938) and vascular comorbidity (discharge/3 months) (R = 0.912), and level 2 comorbidity severity index for respiratory comorbidity (discharge/3 months) (R = 0.941). Conclusion. Rehabilitation treatment of the elderly after hip fracture plays a significant role both in short-term and long-term recovery, particularly in the functional domains even in persons with significant comorbidities. Early inclusion and an individually designed rehabilitation program with continuous monitoring of the elderly after hip fractures results in functional improvement and better quality of life.

scholarly journals Use of the Frailty Tools Fi Mds and Fi Rockwood to Predict Outcomes of Inpatient Rehabilitation after Proximal Hip Fracture

2021 ◽  
Vol 8 (3) ◽  
pp. 01-06
Author(s):  
Jochanan Naschitz
Keyword(s):  
Hip Fracture ◽  
Clinical Decision Making ◽  
Frailty Index ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Elderly Persons ◽  
Clinical Frailty Scale ◽  
The Mean ◽  
The Impact

Background Among factors which affect the outcome of rehabilitation after hip fracture, the role of pre-fracture frailty has not been defined. Objective To assess the impact of frailty on rehabilitation outcome in elderly persons with proximal hip fracture. Setting Geriatric rehabilitation center. Design Retrospective observational study. Subjects Forty consecutive patients with proximal hip fracture. Methods The following parameters were calculated: FI-MDS frailty index, Rockwood Clinical Frailty Scale (FI Rockwood), Functional Independence Measure (FIM) on discharge, absolute functional gain (ΔFIM), length of stay (LOS), and FIM gain per day (ΔFIM/LOS). FIM discharge ≥90 and motor FIM discharge >58 indicated success in rehabilitation. Results There were 31 women and 9 men, mean age 80 years. The mean pre-fracture FI MDS was 10 points (SD 5.8) out of 58 possible, the mean FI Rockwood score was 3 (SD 1.7) out of 7 possible. The mean admission FIM was 76.6 (SD 16), the mean discharge FIM was 92.7 (SD 19.3), mean LOS 22.5 days (SD 9.7), mean ΔFIM/LOS 0.8 (SD 0.6). Pre-fracture frailty was associated with worse outcome of rehabilitation: FI MDS predicted discharge FIM ≥90 with OR 0.86, p 0.012; FI Rockwood predicted discharge FIM ≥90 with OR 0.68, p 0.027; FI MDS predicted discharge motor FIM >58 with OR 0.91, p 0.07; FI Rockwood predicted discharge motor FIM >58 with OR 0.71, p 0.027. Conclusions Though pre-fracture frailty correlated with FIM on discharge, neither frailty tool was specific enough to predict success in rehabilitation and the necessary length of rehabilitation. Translating frailty scores in tools adequate for clinical decision making remains an aim for future studies.

Poster 106 Functional Independence Measure Scores Fail to Identify Patients who Die Following Hip Fracture

PM&R ◽  
2014 ◽  
Vol 6 (9) ◽  
pp. S220
Author(s):  
Leonora Slatnick ◽  
Naim Maalouf ◽  
Benjamin N. Nguyen ◽  
Cindy Dolezal
Keyword(s):  
Hip Fracture ◽  
Functional Independence Measure ◽  
Functional Independence

Impact of place of residence, frailty and other factors on rehabilitation outcomes post hip fracture

2020 ◽  
Author(s):  
Stephanie Low ◽  
Edmund Wee ◽  
Michael Dorevitch
Keyword(s):  
Hip Fracture ◽  
Residential Care ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Community Dwelling ◽  
Hip Fracture Surgery ◽  
Rehabilitation Outcomes ◽  
Poor Outcomes ◽  
Fracture Surgery

Abstract Background Following hip fracture surgery, patients from residential care are frequently excluded from inpatient rehabilitation. We aimed to assess the impact of place of residence and other factors such as frailty on rehabilitation outcomes after hip fracture surgery. Methods Retrospective cohort study. Outcome measures included Functional Independence Measure efficiency, discharge destination and recovery of pre-fracture mobility. Univariable and multivariable linear or logistic regression analyses were performed. Setting One general rehabilitation and two geriatric evaluation and management wards in a large public tertiary teaching hospital. Participants A total of 844 patients who underwent inpatient rehabilitation after hip fracture surgery from 2010 to 2018. Results There were 139 (16%) patients from residential care. Being from residential care was not an independent predictor of poor outcomes. Premorbid frailty (Clinical Frailty Scale) was the strongest independent predictor of poorer Functional Independence Measure efficiency, inability to recover pre-fracture mobility and return to community dwelling. Dementia and delirium were also independently predictive of poor outcomes across all measures. Age &gt; 90 years was independently predictive of inability to recover pre-fracture mobility and return to community dwelling. Conclusion Being from residential care is not independently associated with poor outcomes following inpatient rehabilitation after hip fracture surgery and should not be the basis for excluding these patients from rehabilitation. Major predictors of poorer outcomes include premorbid frailty, dementia, delirium and age &gt; 90 years. If able and motivated, those with potentially reversible functional limitations should be given the opportunity to participate in inpatient rehabilitation as even small gains can have a significant impact on quality of life.

scholarly journals Effects of Tele-Rehabilitation Compared with Home-Based in-Person Rehabilitation for Older Adult’s Function after Hip Fracture

2021 ◽  
Vol 18 (10) ◽  
pp. 5493
Author(s):  
Mariana Ortiz-Piña ◽  
Pablo Molina-Garcia ◽  
Pedro Femia ◽  
Maureen C. Ashe ◽  
Lydia Martín-Martín ◽  
...  
Keyword(s):  
Older Adults ◽  
Hip Fracture ◽  
Functional Recovery ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Control Group ◽  
Control Groups ◽  
Timed Up And Go ◽  
Home Based

This study aimed to examine the effect of a multidisciplinary tele-rehabilitation program on functional recovery of older adults with hip fracture compared with home-based in-person rehabilitation. In this single-blinded, non-randomized clinical trial, we included older with hip fracture. The tele-rehabilitation group received a 12-week tele-rehabilitation program (supervised by their family caregivers). The control group received the usual postoperative rehabilitation provided by the Andalusian health system (Spain). The primary outcome was the patient-reported functional status assessed with the Functional Independence Measure. We also measured performance-based functional recovery using the Timed Up and Go Test and Short Physical Performance Battery. We performed both a per-protocol (62 participants; 28 tele-rehabilitation and 34 control groups) and an intention-to-treat analysis (71 participants; 35 tele-rehabilitation and 36 control groups). Participants who used the tele-rehabilitation program had higher Functional Independence Measure scores (high effect size: 0.98 Cohen’s d; p < 0.001) and better performance in the Timed Up and Go Test (medium effect size: 0.63 Cohen’s d; p = 0.025) compared with the control group. Differences between groups post-intervention were not statistically significant in the Short Physical Performance Battery. The tele-rehabilitation intervention proposed in this study is a valuable treatment option in the recovery process for older adults with hip fracture. ClinicalTrials.gov Identifier: NCT02968589.

Clinically Relevant Behaviors in Elderly Hip Fracture Inpatients

2002 ◽  
Vol 32 (3) ◽  
pp. 249-259 ◽  
Author(s):  
Helen H. Dorra ◽  
Eric J. Lenze ◽  
Yookyung Kim ◽  
Benoit H. Mulsant ◽  
Michael C. Munin ◽  
...  
Keyword(s):  
Mental Health ◽  
Hip Fracture ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Elderly Persons ◽  
Depression And Anxiety ◽  
Rehabilitation Outcome ◽  
Rehabilitation Hospital ◽  
Outcome Behaviors

Objective: To examine the range of behaviors documented by inpatient rehabilitation staff and the association of these behaviors with functional outcome, in elderly persons undergoing rehabilitation after hip fracture. Method: Subjects were 137 patients, aged 60 and older, admitted to a rehabilitation hospital after a hip fracture, defined as having either a good or poor rehabilitation outcome based on change in Functional Independence Measure motor subscale scores during the course of their admission. Their charts were systematically reviewed for nursing and therapy staff documentation of behaviors. Prevalence of behaviors was compared between good and poor rehabilitation outcome groups. Results: Disturbances in cognition and rehabilitation participation were common and were associated with poorer rehabilitation outcome. Behaviors reflective of depression and anxiety were relatively uncommon and not associated with rehabilitation outcome. Conclusions: Rehabilitation staff frequently detect and document disturbances in cognition and participation that are associated with poorer rehabilitation outcome. It is recommended that staff observations be routinely added to mental health evaluations. Additionally, routine mental health screening and required staff documentation of behaviors would improve case detection rate.

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