scholarly journals Effectiveness of a Day Rehabilitation Program in Improving Functional Outcome and Reducing Mortality and Readmission of Elderly Patients With Fragility Hip Fractures

2018 ◽  
Vol 9 ◽  
pp. 215145931875935 ◽  
Author(s):  
Tak Man Wong ◽  
Frankie K. L. Leung ◽  
Tak Wing Lau ◽  
Christian Fang ◽  
Felix H. W. Chan ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Demographic Data ◽  
Rehabilitation Program ◽  
Cognitive Outcomes ◽  
Rehabilitation Service ◽  
World Population ◽  
Rehabilitation Outcomes ◽  
Geriatric Hip Fracture ◽  
Elderly Mobility

Introduction: The incidence of hip fracture is projected to increase in the next 25 years as the world population ages. Hip fracture is often associated with subsequent readmission and mortality. Nevertheless, elderly patients often may not achieve the same level of functional ability as prior to their injury. Several studies have shown that close collaboration between orthopedic surgeons and geriatricians can improve such outcomes and Geriatric Day Hospital (GDH) is one of the examples of collaboration to improve such outcomes. The aim of this descriptive retrospective study is to review the effectiveness of the day rehabilitation program provided by a GDH on functional outcomes, mortality, and readmission rate, among a sample of elderly patients with hip fracture. Methods: The medical records of patients from January 1, 2009, to December 31, 2012, were collected and evaluated. Demographic data of the patients and Charlson Comorbidity Index were collected. The Barthel Index, Elderly Mobility Scale, and Mini-Mental State Examination were measured on admission and at discharge of the patients to evaluate both physical and cognitive functions. Results: The results showed that the majority of patients benefited from rehabilitation in the GDH. The 12-month mortality rate of patients taking full-course rehabilitation in the GDH was improved. The age of patient was the most important factor influencing the rehabilitation outcomes. Gender was the only risk factor for 12-month mortality and 6-month readmission. Discussion: Since patients were selected to attend GDH, there was a bias during the selection of patients. Furthermore, it was difficult to compare patients attended GDH with patients who did not because outcomes of the latter were difficult to be recorded. Conclusions: Our study shows that postoperative geriatric hip fracture patients definitely can benefit from rehabilitation service offered by GDH in terms of functional and cognitive outcomes.

scholarly journals Factors associated to functioning and health in relation to home rehabilitation in Sweden: a non-randomized pre-post intervention study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anette Johansson ◽  
Marie Ernsth Bravell ◽  
Eleonor I. Fransson ◽  
Sofi Fristedt
Keyword(s):  
Repeated Measures ◽  
Linear Models ◽  
Medical Condition ◽  
Rehabilitation Program ◽  
Community Dwelling ◽  
Rehabilitation Service ◽  
Post Intervention ◽  
Factors Associated ◽  
Rehabilitation Outcomes ◽  
Self Rated Health

Abstract Background Home rehabilitation is a growing rehabilitation service in many countries, but scientific knowledge of its components and outcomes is still limited. The aim of this study was to investigate; 1) which changes in functioning and self-rated health could be identified in relation to a home rehabilitation program in a population of community-dwelling citizens, and 2) how socio-demographic factors, health conditions and home rehabilitation interventions were associated to change in functioning and self-rated health after the home rehabilitation program. Method The sample consisted of participants in a municipal home rehabilitation project in Sweden and consisted of 165 community-dwelling citizens. General Linear Models (ANOVA repeated measures) was used for identifying changes in rehabilitation outcomes. Logistic regressions analysis was used to investigate associations between rehabilitation outcomes and potential factors associated to outcome. Result Overall improvements in functioning and self-rated health were found after the home rehabilitation program. Higher frequencies of training sessions with occupational therapists, length of home rehabilitation, and orthopaedic conditions of upper extremities and spine as the main health condition, were associated with rehabilitation outcomes. Conclusion The result indicates that the duration of home rehabilitation interventions and intensity of occupational therapy, as well as the main medical condition may have an impact on the outcomes of home rehabilitation and needs to be considered when planning such programs. However, more research is needed to guide practice and policymaking.

Factors Affecting Short-Term Rehabilitation Outcomes of Disabled Elderly Patients With Proximal Hip Fracture

2007 ◽  
Vol 88 (7) ◽  
pp. 916-921 ◽  
Author(s):  
Avital Hershkovitz ◽  
Zulicha Kalandariov ◽  
Vered Hermush ◽  
Roni Weiss ◽  
Shai Brill
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Short Term ◽  
Factors Affecting ◽  
Rehabilitation Outcomes ◽  
Disabled Elderly

scholarly journals Effect of pre-fracture mobility on the early post-operative functional outcome in elderly patients with a hip fracture

2013 ◽  
Vol 69 (3) ◽  
Author(s):  
S. Adam ◽  
L. Godlwana ◽  
D. Maleka
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Functional Outcome ◽  
The Elderly ◽  
Functional Mobility ◽  
Public Hospitals ◽  
Post Discharge ◽  
Functional Scale ◽  
Post Test ◽  
Elderly Mobility

Background: Hip fractures are among the most commoncauses of disability and hospitalisation in the elderly. There are no studies inSouth Africa that determine the effect of pre-fracture functional mobility onearly post-operative functional outcome in elderly patients with a hip fracture.Aim: The aim of this study was to determine the effect of pre-fracture functionalmobility on early post-operative functional outcome in elderly patients with ahip fracture.Methodology: A prospective pre-test post-test observational study designwas done. Assessments were conducted pre-operatively, at discharge and sixweeks post discharge at two public hospitals in Johannesburg, South Africa. Thepre-fracture functional mobility of the participants was determined using theNew Mobility Score (NMS) pre-operatively. At discharge and at six weeks post discharge the participants post-operative functionallevel was assessed using the Elderly Mobility Scale (EMS) and the Lower Extremity Functional Scale (LEFS).Results: More than two thirds of participants were independently mobile prior to the fracture. Pre-fracture functional mobilityis a strong determinant of early post operative functional outcome in elderly patients with a hip fracture(β = 1.39, p = 0.0001).Conclusion: Independent pre-fracture mobility predicts better early post-operative functional outcomes in the elderly.

scholarly journals Prevalence of Swallowing and Eating Difficulties in an Elderly Postoperative Hip Fracture Population—A Multi-Center-Based Pilot Study

Geriatrics ◽  
2020 ◽  
Vol 5 (3) ◽  
pp. 52 ◽  
Author(s):  
Gitte Madsen ◽  
Stine M. Kristoffersen ◽  
Mark R. Westergaard ◽  
Vivi Gjødvad ◽  
Merete M. Jessen ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Pilot Study ◽  
Elderly Patients ◽  
Demographic Data ◽  
Cross Sectional ◽  
Factors Associated ◽  
Volume Viscosity ◽  
Fracture Population ◽  
High Age ◽  
High Degree

Elderly patients operated for hip fracture are characterized by high age and high degree of comorbidity and need of care, factors previously found to be associated with swallowing and eating difficulties. The aim of this study was to investigate the prevalence of swallowing and eating difficulties in an elderly postoperative hip fracture population and to identify factors associated with swallowing and eating difficulties. A cross-sectional multi-center pilot study was performed, including patients ≥65 years, operated for hip fracture, and able to participate in a swallowing and eating assessment. A clinical assessment was conducted using Danish versions of the standardized tools Volume-Viscosity Swallow Test and Minimal Eating Observation Form-version II. Demographic data and clinical characteristics were examined. A total of 78 patients (mean age 81.4 years (SD 7.8), 30.8% male) were included. Swallowing and eating difficulties were present in 60 patients (77%). Swallowing and eating difficulties were significantly associated with living in a nursing home before hospital admission (p = 0.014), low habitual New Mobility Score (p = 0.018), and absence of cardiac comorbidity (p = 0.023). The results underline the importance of focusing on swallowing and eating difficulties in elderly patients operated for hip fracture to ensure effectivity and safety and optimize the prognosis for the patient.

scholarly journals Rehabilitative Exercise Reduced the Impact of Peripheral Artery Disease on Vascular Outcomes in Elderly Patients with Claudication: A Three-Year Single Center Retrospective Study

2019 ◽  
Vol 8 (2) ◽  
pp. 210 ◽  
Author(s):  
Fabio Manfredini ◽  
Nicola Lamberti ◽  
Franco Guerzoni ◽  
Nicola Napoli ◽  
Vincenzo Gasbarro ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Peripheral Artery Disease ◽  
Ankle Brachial Index ◽  
Rehabilitation Program ◽  
Peripheral Artery ◽  
Rehabilitation Outcomes ◽  
Home Based ◽  
Severe Group ◽  
Artery Disease ◽  
The Impact

The study retrospectively evaluated the association between rehabilitative outcomes and risk of peripheral revascularizations in elderly peripheral artery disease (PAD) patients with claudication. Eight-hundred thirty-five patients were enrolled. Ankle-brachial index (ABI) and maximal walking speed (Smax) were measured at baseline and at discharge from a structured home-based rehabilitation program. For the analysis, patients were divided according to a baseline ABI value (severe: ≤0.5; moderate: ≥0.5) and according to hemodynamic or functional rehabilitative response (responder: ABI ≥0.10 and/or Smax >0.5 km/h). Three-year outcomes were collected from the regional registry. According to the inclusion criteria (age 60–80, ABI <0.80; program completion) 457 patients, 146 severe and 311 moderate, were studied. The whole population showed significant functional and hemodynamic improvements at discharge, with 56 revascularizations and 69 deaths at follow-up. Compared to the moderate group, the severe group showed a higher rate of revascularizations (17% vs. 10%, p < 0.001) and deaths (29% and 8%, respectively; p < 0.001). However, patients with severe PAD who were ABI responders after rehabilitation showed less revascularizations than non-responders (13% vs. 21%; hazard ratio (HR): 0.52) and were not different from patients with moderate disease (9%). Superimposable rates were observed for Smax responders (13% vs. 21%; HR: 0.55; moderate 10%). In conclusion, elderly patients with severe PAD empowered by better rehabilitation outcomes showed lower rates of peripheral revascularizations and deaths that were comparable to patients with moderate PAD.

scholarly journals Analysis of Home-Based Rehabilitation Awareness, Needs and Preferred Components of Elderly Patients with Hip Fracture Surgery in South Korea

2021 ◽  
Vol 18 (14) ◽  
pp. 7632
Author(s):  
Haneul Lee ◽  
Seon-Heui Lee
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
South Korea ◽  
Cost Effective ◽  
Rehabilitation Program ◽  
Hip Fracture Surgery ◽  
Home Based ◽  
Motivational Support ◽  
Hospital Rehabilitation ◽  
Fracture Surgery

The importance and necessity of home-based rehabilitation with professional and systematic interventions should be considered since home-based rehabilitation has been institutionalized as it is more feasible, cost effective, and even safer than in-hospital rehabilitation in most countries—though not in South Korea. In addition, the need for home-based rehabilitation is increasing due to the increasing number of hip fracture patients and limited capacity of acute hospital rehabilitation. Therefore, the purpose of this study was to investigate the awareness, needs, and preferred components of home-based rehabilitation services after discharge for elderly patients with hip fracture surgery in South Korea. A survey of 98 elderly patients who recently underwent hip fracture surgery was performed using a questionnaire. More than 75% of patients agreed on the need for home-based rehabilitation, even though most had never heard of it. The reason for the need for home-based rehabilitation was that it is possible to receive continuously ongoing treatment (53.0%), and it alleviates the inconvenience of visiting hospitals (27.7%). In addition to this, about 15.7% of patients responded that they could achieve mental comfort. In other words, patients can recover in an emotionally stable environment without the psychological anxiety they might experience in hospital. Thus, in order to maximize the effectiveness of home-based rehabilitation and provide comprehensive guidance including exercise, education, motivational support, and environmental modification, to patients undergoing hip fracture surgery, the component of the rehabilitation program must be developed based upon rehabilitation experts’ knowledge and patients’ value. Additionally, corresponding policies should be established.

scholarly journals Post-hip fracture rehabilitation outcomes of diabetic and non-diabetic elderly patients

2021 ◽  
Vol 53 (1) ◽  
pp. 2298-2304
Author(s):  
Ronen Ben-Joseph ◽  
Barak Luboshitz ◽  
Rachel Heffez Ayzenfeld ◽  
Orit Twito
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Rehabilitation Outcomes

Obesity and Metabolic Syndrome in a Psychiatric Rehabilitation Service

2007 ◽  
Vol 41 (7) ◽  
pp. 606-610 ◽  
Author(s):  
Srinivasan Tirupati ◽  
Ling-Ern Chua
Keyword(s):  
Metabolic Syndrome ◽  
Metabolic Disorders ◽  
Psychotic Disorders ◽  
Psychiatric Rehabilitation ◽  
International Diabetes Federation ◽  
Rehabilitation Program ◽  
Management Program ◽  
Rehabilitation Service ◽  
Rehabilitation Outcomes ◽  
Prevalence Of Obesity

Objective: People with schizophrenia and bipolar disorders suffer from increased rates of obesity and metabolic syndrome. Metabolic disorders add to the burden of disease and affect treatment and rehabilitation outcomes. This study aimed to study the prevalence of obesity and metabolic syndrome in people with chronic psychotic disorders in a psychiatric rehabilitation setting. Method: All patients in the psychiatry rehabilitation program were assessed for obesity and metabolic syndrome using the definition of International Diabetes Federation (2005) was conducted as part of clinical protocol recently introduced into practice. Results: A total of 221 patients were assessed. The prevalence of obesity was 59% and metabolic syndrome 68%. Metabolic syndrome was more frequent in patients receiving polypharmacy with multiple antipsychotics and mood stabilisers. Rates of nontreatment for metabolic disorders ranged from 30% to 88%. Conclusions: The rates of obesity and metabolic syndrome in patients with chronic severe mental disorders on antipsychotic drug treatment were 2 to 3 times that in the general population. A majority of them were untreated. Detection, monitoring and appropriate treatment of obesity and metabolic disorders should be a component of an assertive care management program to reduce morbidity and mortality and improve rehabilitation outcomes.

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