scholarly journals Effects of fragility fracture integrated rehabilitation management on mobility, activity of daily living and cognitive functioning in elderly with hip fracture

2020 ◽  
Vol 36 (5) ◽  
Author(s):  
Anam Aftab ◽  
Waqar Ahmed Awan ◽  
Shaista Habibullah ◽  
Jae Young Lim
Keyword(s):  
Hip Fracture ◽  
Activities Of Daily Living ◽  
Cognitive Functioning ◽  
Fragility Fracture ◽  
Daily Living ◽  
Stair Climbing ◽  
Walking Ability ◽  
Bipolar Hemiarthroplasty ◽  
Activity Of Daily Living ◽  
Rehabilitation Management

Objective: To determine the effectiveness of Fragility Fracture Integrated Rehabilitation Management (FIRM) on mobility, activity of daily living and cognitive functioning in elderly with hip fracture. Methods: A randomized control trial was conducted at Seoul National University Bundang Hospital, South Korea from August 2017 to January 2018. Patients of both genders with the age 65-95 years, diagnosed cases of hip fracture specifically fractures neck of femur, intertrochanteric, subtrochantric, patients who got bipolar hemiarthroplasty, total hip replacement arthroplasty, reduction and internal fixation were included in this study. A total of n=39 sample was collected through non probability convenience sampling technique and randomly divided into Fragility Integrated Rehabilitation Management (FIRM) group (n=20) and Conventional Physical therapy (CPT) group (n=19). The data was collected through KOVAL for walking ability, modified barthal index (MBI) for behaviors related to activities of daily living (ADLS) and mini mental status examination (MMSE) for cognitive functions at baseline on 2nd postoperative day and after 10th FIRM session on 15th postoperative day. Results: The mean age of study participants was 82.07±6.00 years. The post intervention comparison did not show any significant difference (p>0.05) in walking ability, overall ADLs and cognitive functioning. But FIRM group showed significant improvement in stair climbing {0(5) ver. 2(7.5), p=0.049} and ambulation or walker use {8(5) ver. 2(4), p=0.037}, as compared to CPT group. Conclusion: Both groups improved in indoor mobility with walker and crutches as well as activities of daily living. But FIRM showed more improving ambulation with walker and stair climbing. While cognitive functioning was observed only in FIRM group. ClinicalTrials.gov Identifier: NCT03430193. https://clinicaltrials.gov/ct2/show/NCT03430193. doi: https://doi.org/10.12669/pjms.36.5.2412 How to cite this:Aftab A, Awan WA, Habibullah S, Lim JY. Effects of fragility fracture integrated rehabilitation management on mobility, activity of daily living and cognitive functioning in elderly with hip fracture. Pak J Med Sci. 2020;36(5):---------.   doi: https://doi.org/10.12669/pjms.36.5.2412 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals No Major Differences in Recovery After Hip Fracture Between Home-Dwelling Female and Male Patients

2019 ◽  
Vol 109 (3) ◽  
pp. 250-264
Author(s):  
A. Lahtinen ◽  
J. Leppilahti ◽  
H. Vähänikkilä ◽  
S. Kujala ◽  
J. Ristiniemi ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Activities Of Daily Living ◽  
Mortality Risk ◽  
Daily Living ◽  
Walking Ability ◽  
Residential Status ◽  
Men And Women ◽  
Male Patients ◽  
American Society ◽  
American Society Of Anesthesiologists

Background: Studies comparing recovery of men and women after hip fracture have reported conflicting results, some reporting worse recovery in male patients, while others found no differences between genders. Methods: Recovery was compared in 105 male and 433 female patients with hip fractures and in age-matched groups of patients 50 years or older, who were home-dwelling and received similar rehabilitation. Residential status, walking ability, hip pain and activities of daily living function were recorded at admission and 4 and 12 months postoperatively, along with mortality and re-operations. Results: No differences were observed between men and women 4 and 12 months postoperatively regarding residential status (p = 0.181 vs p = 0.883), mortality rates (p = 0.232 vs p = 0.880) or total activities of daily living scores (p = 0.546 vs p = 0.435). Walking ability was better among male patients prefracture (p < 0.001) and 4 and 12 months after fracture (p < 0.001, p = 0.031, respectively). In age-matched pair analysis, no differences were found regarding mortality, residential status, walking ability, or ADL score. Cox regression analysis identified mortality risk factors as being age, prefracture ADL score, American Society of Anesthesiologists score 4–5 and place of rehabilitation. Sex was not mortality risk factor. Interpretation: Home-dwelling male and female patients had similar courses of recovery from hip fracture, although there were singular differences in specific activities of daily living functions and postoperative pain. There were no differences in mortality, even when prefracture characteristics were considered. Mortality was higher among older patients and who had high American Society of Anesthesiologists scores and low prefracture activities of daily living scores.

scholarly journals EFFECTS OF FRAGILITY FRACTURE INTEGRATED REHABILITATION MANAGEMENT HIP FRACTURE IN PAKISTANI OLDER ADULTS

2021 ◽  
Vol 5 (1) ◽  
pp. 192-197
Author(s):  
Anam Aftab ◽  
◽  
Shaista Habibullah ◽  
Nimra Ilyas Bhutta ◽  
◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Hip Fracture ◽  
Fragility Fracture ◽  
Personal Hygiene ◽  
Walking Ability ◽  
Rehabilitation Management ◽  
Hip Fracture Surgery ◽  
Fracture Surgery

Objective: to evaluate the effectiveness of fragility Fracture Integrated Rehabilitation Management (FIRM) on older adults of Pakistan after hip fracture surgery. Methodology: A one-group pretest–posttest designwas conducted at the National Institute of Rehabilitation Medicine (NIRM), Islamabad from March 2020 to May 2021.. A n=11 participants with age above 55 years, both male and female, with confirming diagnosed cases of hip fracture were included. Every participats receveied 10 sesssions of Fragility Fracture integrated Rehabilitation Management (FIRM) program in two weeks. Data was collected at baseline at 2nd day and after 10th session on 15th day, through the KOVAL scale to assess the walking ability, the Functional Ambulatory Category (FAC) to assess the level of independence, the modified Barthel index (MBI) for activities of daily living (ADLs), and quality of life (QoL) was assessed by EQ-5D. Data were analyzed by using SPSS Version 21. Result: the mean age 76.45±9.32, of which n=6 (54.6%) were males and n=5(45.4%) were females. after 10th sessions the QoL on EQ-5D, ambulation on FAC and KOVAL scale and the ADL on MBI were significantly improved (p<0.05) with large effect size, except for the anxiety domain of EQ5D and subdomains of MBI; Personal hygiene, feeding, Bowel control, bladder control, Wheelchair, and Chair & bed transfer showed no significant change (p>0.05). Conclusion: FIRM care is found to be effective in improving the walking ability, functional status, ADLs and quality of life in geraiatric population following a hip fracture surgery

scholarly journals EFFECTIVENESS OF FRAGILITY FRACTURE INTEGRATED REHABILITATION MANAGEMENT FOR IMPROVING ACTIVITY OF DAILY LIVING AND QUALITY OF LIFE IN GERIATRIC POPULATION AFTER HIP FRACTURE

2020 ◽  
Vol 4 (1) ◽  
pp. 139-143
Author(s):  
Anam Aftab ◽  
◽  
Rizwana Butt ◽  
Shaista Habibullah ◽  
Jae Young Lim ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hip Fracture ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Rank Test ◽  
Rehabilitation Management ◽  
Geriatric Population ◽  
National University ◽  
Seoul National University

Objective: The objective of the study was to determine the efficacy of Fragility Integrated Rehabilitation Management (FIRM) on the quality of life and activities of daily living in geriatric population with hip fracture and to reduce the recurrence of hip fracture. Material and Method: A single-group, pretest–posttest design was conducted at Seoul National University for a time period from August 2017 to January 2018 in Bundang Hospital, South Korea. Patients with age of 55 years and above, had diagnosed femoral neck fractures, reduction and internal fixation, intertrochanteric and sub-trochanteric fractures, total hip replacement (THR), bipolar hemi-arthroplasty were included in the study. Quality of life was assessed through the Euro-QOL (EQ-5D) questionnaire, while ADL’s was measured through Modified Barthal Index (MBI). Non-parametric Wilcoxon Sign Rank test was used for pre- post analysis by using SPSS version 21. The level of significance was set at 95% CI (p<0.05). Results: Wilcoxon signed rank test showed a significant improvement in activities of daily living (p<0.05). Furthermore, significant improvement has also been determined in the quality of life (p<0.05), after the 10th Fragility Integrated Rehabilitation Management (FIRM) and 4 Occupational Therapy (OT) sessions. Conclusion: Fragility Integrated Rehabilitation Management showed a significant improvement in the Activities of Daily Living (ADLs) and Quality of Life (QOL).

scholarly journals Improved outcome in hip fracture patients in the aging population following co-managed care compared to conventional surgical treatment: a retrospective, dual-center cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Carl Neuerburg ◽  
Stefan Förch ◽  
Johannes Gleich ◽  
Wolfgang Böcker ◽  
Markus Gosch ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hip Fracture ◽  
Activities Of Daily Living ◽  
Trauma Care ◽  
Daily Living ◽  
Aging Population ◽  
Readmission Rates ◽  
Term Outcome ◽  
Long Term Outcome

Abstract Background Hip fracture patients in the aging population frequently present with various comorbidities, whilst preservation of independency and activities of daily living can be challenging. Thus, an interdisciplinary orthogeriatric treatment of these patients has recognized a growing acceptance in the last years. As there is still limited data on the impact of this approach, the present study aimed to evaluate the long-term outcome in elderly hip fracture patients, by comparing the treatment of a hospital with integrated orthogeriatric care (OGC) with a conventional trauma care (CTC). Methods We conducted a retrospective, two-center, cohort study. In two maximum care hospitals all patients presenting with a hip fracture at the age of ≥ 70 years were consecutively assigned within a 1 year period and underwent follow-up examination 12 months after surgery. Patients treated in hospital site A were treated with an interdisciplinary orthogeriatric approach (co-managed care), patients treated in hospital B underwent conventional trauma care. Main outcome parameters were 1 year mortality, readmission rate, requirement of care (RC) and personal activities of daily living (ADL). Results A total of 436 patients were included (219 with OGC / 217 with CTC). The mean age was 83.55 (66–99) years for OGC and 83.50 (70–103) years for CTC (76.7 and 75.6% of the patients respectively were female). One year mortality rates were 22.8% (OGC) and 28.1% (CTC; p = 0.029), readmission rates were 25.7% for OGC compared to 39.7% for CTC (p = 0.014). Inconsistent data were found for activities of daily living. After 1 year, 7.8% (OGC) and 13.8% (CTC) of the patients were lost to follow-up. Conclusions Interdisciplinary orthogeriatric management revealed encouraging impact on the long-term outcome of hip fracture patients in the aging population. The observed reduction of mortality, requirements of care and readmission rates to hospital clearly support the health-economic impact of an interdisciplinary orthogeriatric care on specialized wards. Trial registration The study was approved and registered by the bavarian medical council (BLAEK: 7/11192) and the local ethics committee of munich university (Reg. No. 234–16) and was conducted as a two-center, cohort study at a hospital with integrated orthogeriatric care and a hospital with conventional trauma care.

scholarly journals Risk Model for Decline in Activities of Daily Living Among Older Adults Hospitalized With Acute Myocardial Infarction: The SILVER‐AMI Study

2020 ◽  
Vol 9 (19) ◽  
Author(s):  
Alexandra M. Hajduk ◽  
John A. Dodson ◽  
Terrence E. Murphy ◽  
Sui Tsang ◽  
Mary Geda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Older Patients ◽  
Risk Model ◽  
Functional Decline ◽  
Activity Of Daily Living ◽  
Mobility Impairment

Background Functional decline (ie, a decrement in ability to perform everyday activities necessary to live independently) is common after acute myocardial infarction (AMI) and associated with poor long‐term outcomes; yet, we do not have a tool to identify older AMI survivors at risk for this important patient‐centered outcome. Methods and Results We used data from the prospective SILVER‐AMI (Comprehensive Evaluation of Risk Factors in Older Patients With Acute Myocardial Infarction) study of 3041 patients with AMI, aged ≥75 years, recruited from 94 US hospitals. Participants were assessed during hospitalization and at 6 months to collect data on demographics, geriatric impairments, psychosocial factors, and activities of daily living. Clinical variables were abstracted from the medical record. Functional decline was defined as a decrement in ability to independently perform essential activities of daily living (ie, bathing, dressing, transferring, and ambulation) from baseline to 6 months postdischarge. The mean age of the sample was 82±5 years; 57% were men, 90% were White, and 13% reported activity of daily living decline at 6 months postdischarge. The model identified older age, longer hospital stay, mobility impairment during hospitalization, preadmission physical activity, and depression as risk factors for decline. Revascularization during AMI hospitalization and ability to walk a quarter mile before AMI were associated with decreased risk. Model discrimination (c=0.78) and calibration were good. Conclusions We identified a parsimonious model that predicts risk of activity of daily living decline among older patients with AMI. This tool may aid in identifying older patients with AMI who may benefit from restorative therapies to optimize function after AMI.

scholarly journals Survival, disabilities in activities of daily living, and physical and cognitive functioning among the oldest-old in China: a cohort study

The Lancet ◽  
2017 ◽  
Vol 389 (10079) ◽  
pp. 1619-1629 ◽  
Author(s):  
Yi Zeng ◽  
Qiushi Feng ◽  
Therese Hesketh ◽  
Kaare Christensen ◽  
James W Vaupel
Keyword(s):  
Cohort Study ◽  
Activities Of Daily Living ◽  
Cognitive Functioning ◽  
Daily Living ◽  
Oldest Old

Reliability and Validity Testing of the Self-Efficacy for Functional Activities Scale

1999 ◽  
Vol 7 (1) ◽  
pp. 5-20 ◽  
Author(s):  
Barbara Resnick
Keyword(s):  
Self Efficacy ◽  
Daily Living ◽  
Specific Activity ◽  
Reliability And Validity ◽  
The Self ◽  
Stair Climbing ◽  
Activity Of Daily Living ◽  
Validity Testing ◽  
Functional Activities ◽  
Efficacy Expectations

Self-efficacy expectations for functional activities were defined operationally by having individuals rate their perceived judgment or confidence in their ability to perform each specific activity of daily living (ADL) (bathing, dressing, transferring, ambulating, and stair climbing) at a given point in time. The Self-Efficacy for Functional Activities (SEFA) scale initially included 27 items focusing on efficacy expectations related to performance of each ADL independently, with adaptive equipment, and with the help of another person. After initial pilaf testing the scale was revised to include 9 items which focused on efficacy expectations related to performance of each ADL independently, or with the help of another person. Two additional studies were done and provided some evidence for the reliability and validity of the SEFA when used with older adults.

Factors Predicting Mobility and the Change in Activities of Daily Living After Hip Fracture

2016 ◽  
Vol 30 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Massimo Mariconda ◽  
Giovan Giuseppe Costa ◽  
Simone Cerbasi ◽  
Pasquale Recano ◽  
Gianclaudio Orabona ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Activities Of Daily Living ◽  
Daily Living
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