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

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.

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

Acta Médica Portuguesa ◽

10.20344/amp.4267 ◽

2014 ◽

Vol 27 (1) ◽

pp. 88 ◽

Cited By ~ 1

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

Introduction: 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. Material and Methods: 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). Results: 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. Discussion: The most significant improvement is obtained for women in first and third age groups and with higher SI. Conclusion: 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).

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The Functional Independence Measure and the Functional Assessment Measure (FIM + FAM) as an effective tool for the evaluation of functional status in stroke rehabilitation

Ukrainian Neurological Journal ◽

10.30978/unj2021-1-2-43 ◽

2021 ◽

Author(s):

L. Shuranova ◽

J. Vacková

Keyword(s):

Functional Assessment ◽

Clinical Decision Making ◽

Rating Scale ◽

Functional Independence Measure ◽

Functional Independence ◽

Hospital Treatment ◽

Common Cause ◽

Assessment Measure ◽

Rehabilitation Period

The Functional Independence Measure and Functional Assessment Measure (FIM + FAM) is an effective, efficient, and objective tool for tracking changes in the motor, cognitive, and psychosocial functions of patients over the entire treatment and rehabilitation period. It is estimated that in the Czech Republic (CR), stroke is the third most common cause of death and the most common cause of adult disability. To develop faster, better, and more cost‑effective stroke treatments and reduce or mitigate functional losses and restrictive situations, it is very important that patients be objectively evaluated, relative to their functional abilities, as soon as possible after a stroke. A critical part of stroke treatment is to calculate the length of in‑hospital treatment and estimate the length of the rehabilitation period after the stroke. Contemporary methods for evaluating and analyzing a patient’s condition are based on test results and evidence.The FIM offers a more sensitive rating scale compared to BI due to the presence of cognitive items and is used worldwide for assessment during the acute stage of the disease. Thus, it is an efficient instrument for setting therapy goals and evaluating the effects of rehabilitation. Not only can it assist the therapist in clinical decision making, but it also functions as a tool for evaluating rehabilitation outcomes. Based on this test, short‑term and long‑term rehabilitation plans can be determined. At the end of the rehabilitation process, assessing the patient’s functional condition helps to predict the specific long‑term rehabilitation services the patient will need as they return to society and regain their quality of life.

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Effectiveness of Robot-Assisted Gait Training on Functional Skills in Children with Cerebral Palsy

Journal of Pediatric Neurology ◽

10.1055/s-0041-1725128 ◽

2021 ◽

Author(s):

Burak Yaşar ◽

Emine Atıcı ◽

Derya Azim Razaei ◽

Tülay Çevik Saldıran

Keyword(s):

Cerebral Palsy ◽

Functional Independence Measure ◽

Gait Training ◽

Functional Independence ◽

Rehabilitation Program ◽

Robot Assisted ◽

Timed Up And Go ◽

Motor Functions ◽

Significant Difference ◽

Children With Cerebral Palsy

AbstractThis study was aimed to investigate the effects of robot-assisted gait training (RAGT) on motor functions, spasticity status, balance, and functionality in children with cerebral palsy (CP). A total of 26 patients who were diagnosed with CP (diplegic, with gross motor function classification system [GMFCS] levels of 2–5) and who regularly participated in a rehabilitation program were recruited in the study after obtaining approval from their parents. The patients were randomly assigned to two groups. Group 1 (n = 13) received conventional physical therapy (65 minutes, 2 days/week × 8) and group 2 (n = 13) received 25 minutes of RAGT (RoboGait) in addition to conventional therapy (CT; 40 minutes, 2 days/week × 8). GMFCS was used to evaluate motor functions and the Modified Ashworth Scale was used to evaluate spasticity. The pediatric Berg balance scale, pediatric functional independence measure, and timed up and go tests were employed to assess balance and functional status. The evaluations were performed at baseline and after 8 weeks of therapy. Both rehabilitation methods led to a statistically significant decrease in spasticity (p < 0.05); however, there was no difference in this improvement of spasticity between the groups (p > 0.05). Both groups exhibited significant improvements in functional independence, balance, and performance at the end of therapy (p < 0.05), and there was no significant difference between the groups (p > 0.05). The results of this study show that addition of RAGT to CT for 8 weeks is not superior to CT alone in children with CP.

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Gender and Musculoskeletal Comorbidity Impact on Physical Functioning in Elderly after Hip Fracture: The Role of Rehabilitation

Healthcare ◽

10.3390/healthcare8010031 ◽

2020 ◽

Vol 8 (1) ◽

pp. 31

Author(s):

Katarina Radosavljevic ◽

Gordana Dragovic-Lukic ◽

Dejan Nikolic ◽

Pavle Radovic ◽

Biljana Milicic ◽

...

Keyword(s):

Hip Fracture ◽

Physical Functioning ◽

Rating Scale ◽

Rehabilitation Program ◽

Functional Improvement ◽

Post Discharge ◽

Sf 36 ◽

Significant Difference

The study aim was to evaluate the effects of presence and level of musculoskeletal impairment along with gender on physical functioning outcome after the rehabilitation program in aged adults with a hip fracture. We analyzed 203 elderly people with hip fractures above 65 years of age that were treated after the hip surgery. According to the time of examination, patients were tested three times: at admission, discharge, and at three months post-discharge. Musculoskeletal impairments were analyzed, and for the estimation of severity of degree impairment, we used a cumulative index rating scale for geriatrics (CIRS-G). Regarding the gender, we separately analyzed males and females. To evaluate physical functioning of aged adults after a hip fracture, we used the physical functioning component (PFC) from the quality of life (SF-36) questionnaire. For males, on all three occasions we found non-significant differences were found in SF-36 PFC values between different degrees of CIRS-G musculoskeletal impairment. A significant difference was noticed in females three months post-discharge. Effects size of different examination periods for every CIRS-G severity degree of musculoskeletal impairment were high, where males had higher values for severity degrees 1 and 2, and females had higher values for severity degrees 0 and 3. Our findings might suggest that there is a certain degree of different rehabilitation treatment effects for males versus females. Moreover, it might be assumed that other factors could influence different degrees of functional improvement and outcome of individuals after a hip fracture with musculoskeletal impairment.

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How Do Geriatric Scores Predict 1-Year Mortality in Elderly Patients with Suspected Pneumonia?

Geriatrics ◽

10.3390/geriatrics6040112 ◽

2021 ◽

Vol 6 (4) ◽

pp. 112

Author(s):

Alberto Nascè ◽

Astrid Malézieux-Picard ◽

Landry Hakiza ◽

Thomas Fassier ◽

Dina Zekry ◽

...

Keyword(s):

Elderly Patients ◽

Rating Scale ◽

Nutritional Assessment ◽

Univariate Analysis ◽

Mini Nutritional Assessment ◽

Functional Independence Measure ◽

Functional Independence ◽

Long Term Outcomes ◽

Long Term Prognosis

Background: Pneumonia has an impact on long-term mortality in elderly patients. The risk factors associated with poor long-term outcomes are understated. We aimed to assess the ability of scores that evaluate patients’ comorbidities (cumulative illness rating scale—geriatric, CIRS-G), malnutrition (mini nutritional assessment, MNA) and functionality (functional independence measure, FIM) to predict 1-year mortality in a cohort of older patients having a suspicion of pneumonia. Methods: Our prospective study included consecutive patients over 65 years old and hospitalized with a suspicion of pneumonia enrolled in a monocentric cohort from May 2015 to April 2016. Each score was analysed in univariate and multivariate models and logistic regressions were used to identify contributors to 1-year mortality. Results: 200 patients were included (51% male, mean age 83.8 ± 7.7). Their 1-year mortality rate was 30%. FIM (p < 0.01), CIRS-G (p < 0.001) and MNA (p < 0.001) were strongly associated with poorer long-term outcomes in univariate analysis. CIRS-G (p < 0.05) and MNA (p < 0.05) were significant predictors of 1-year mortality in multivariate analysis. Conclusion: Long-term prognosis of patients hospitalized for pneumonia was poor and we identified that scores assessing comorbidities and malnutrition seem to be important predictors of 1-year mortality. This should be taken into account for evaluating elderly patients’ prognosis, levels and goals of care.

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Correlation between demographic characteristics, cognitive functioning and functional independence in stroke patients

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1602031a ◽

2016 ◽

Vol 144 (1-2) ◽

pp. 31-37 ◽

Cited By ~ 3

Author(s):

Sladjana Arsic ◽

Ljubica Konstantinovic ◽

Fadilj Eminovic ◽

Dragan Pavlovic

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Functional Independence Measure ◽

The Elderly ◽

Functional Independence ◽

Demographic Characteristics ◽

Stroke Patients ◽

Diabetes Mellitus Type Ii ◽

Significant Difference ◽

And Gender

Introduction. It has been assumed that there is causality of the achieved level of functional independence with the degree of preservation of cognitive function in stroke patients. Demographic characteristics may be important for monitoring the achieved level of functional independence. Objective. The aim of this study was to examine the relationship of demographic characteristics and functional independence in regard to the level of cognitive impairment in stroke patients. Methods. The study included 50 stroke patients after rehabilitation, as well as age- and gender-matched 50 subjects selected randomly, according to the demographic characteristics of the studied sample, who in their medical history had no neurological disorders. For the assessment of functional independence, the Functional Independence Measure (FIM) test was used. The general cognition was estimated by the Mini-Mental State Examination (MMSE) test. The statistical analyses included the Mann-Whitney test, for two independent samples, measures of canonical correlation, and ?2 test. Results. There was a statistically significant difference between the groups in relation to risk factors, hypertension and diabetes mellitus type II (p<0.001); There was a statistically significant difference within the groups in relation to the cognitive impairment in all the examined demographic characteristics (p<0.001); the differences within the groups in relation to the cognitive impairment are present on all subscales of the FIM test (p<0.05); the differences within the groups in relation to handedness, hemiparesis, show that mild cognitive impairment is more common among left hemiparesis, while a more severe one is more common among right-sided hemiparesis (p<0.05); More severe cognitive impairment is common among women, the elderly and in persons with lower education (p<0.05). Conclusion. By prevention of risk factors, and prevention of possible cognitive impairment, consequences of stroke can be reduced, the recovery can be made more successful, and quality of life can be improved.

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105493 ◽

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.

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Functional independence of the elderly in multiprofessional home care

Acta Scientiarum Health Sciences ◽

10.4025/actascihealthsci.v41i1.43168 ◽

2019 ◽

Vol 41 (1) ◽

pp. 43168

Author(s):

Talita Ferreira Turatti do Carvalhal ◽

Elenize Losso ◽

Leon Martins Boava ◽

Suzane Ketlyn Martello ◽

Manoela De Paula Ferreira ◽

...

Keyword(s):

Home Care ◽

Care Service ◽

Circulatory System ◽

Functional Independence Measure ◽

Care Program ◽

The Elderly ◽

Functional Independence ◽

Functional Evaluation ◽

Significant Difference ◽

Clinical Diagnoses

Functional evaluation is one of the pillars of elderly home care for planning of interventions targeting the autonomy of this population. To verify Functional Independence Measure (FIM) in senior patients on a home care program. Retrospective quantitative study with elderly patients assisted by a home care service in the city of Curitiba, from August 2012 to December 2016. The following information was collected: gender, age, clinical diagnosis, and mean FIM scores at admission and discharge. Inclusion and exclusion criteria were met, descriptive statistics was used and, for association of variables, Wilcoxon’s and Spearman’s tests were applied. 1,614 patients were included, with predominance of women (n = 953; 59.53%), mean age of 78.7 ± 9.2 years, clinical diagnoses of diseases mostly affecting the central nervous system (CNS), the respiratory system, the joint and musculoskeletal system, and the circulatory system. The initial mean FIM was 50.56 points, while the final one was 55.36 points, with significant difference – Z = -5.09, p = 0.0001. Most seniors presented maximum to moderate dependence; however, a significant improvement in FIM after the health care provided in their homes was observed in patients with minimum dependence or modified independence.

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The impact of COVID-19 infection on hip fracture 30-day mortality

Trauma ◽

10.1177/1460408620949725 ◽

2021 ◽

pp. 146040862094972

Author(s):

Ahmed Fadulelmola ◽

Rob Gregory ◽

Gavin Gordon ◽

Fiona Smith ◽

Andrew Jennings

Keyword(s):

Hip Fracture ◽

Hip Fractures ◽

Hospital Admissions ◽

The Elderly ◽

Primary Outcome Measure ◽

Time To Death ◽

Significant Difference ◽

The Mean ◽

The Impact ◽

Mean Time

Introduction: A novel virus, SARS-CoV-2, has caused a fatal global pandemic which particularly affects the elderly and those with comorbidities. Hip fractures affect elderly populations, necessitate hospital admissions and place this group at particular risk from COVID-19 infection. This study investigates the effect of COVID-19 infection on 30-day hip fracture mortality. Method: Data related to 75 adult hip fractures admitted to two units during March and April 2020 were reviewed. The mean age was 83.5 years (range 65–98 years), and most (53, 70.7%) were women. The primary outcome measure was 30-day mortality associated with COVID-19 infection. Results: The COVID-19 infection rate was 26.7% (20 patients), with a significant difference in the 30-day mortality rate in the COVID-19-positive group (10/20, 50%) compared to the COVID-19-negative group (4/55, 7.3%), with mean time to death of 19.8 days (95% confidence interval: 17.0–22.5). The mean time from admission to surgery was 43.1 h and 38.3 h, in COVID-19-positive and COVID-19-negative groups, respectively. All COVID-19-positive patients had shown symptoms of fever and cough, and all 10 cases who died were hypoxic. Seven (35%) cases had radiological lung findings consistent of viral pneumonitis which resulted in mortality (70% of mortality). 30% ( n = 6) contracted the COVID-19 infection in the community, and 70% ( n = 14) developed symptoms after hospital admission. Conclusion: Hip fractures associated with COVID-19 infection have a high 30-day mortality. COVID-19 testing and chest X-ray for patients presenting with hip fractures help in early planning of high-risk surgeries and allow counselling of the patients and family using realistic prognosis.

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Dance, functioning and quality of life in children with Down syndrome and autism spectrum disorder dance, functioning and quality of life in Down syndrome and autism spectrum disorder

Clinical Child Psychology and Psychiatry ◽

10.1177/13591045211061795 ◽

2021 ◽

pp. 135910452110617

Author(s):

Evanilza T. Adorno ◽

Daiany C de J. Dos Santos ◽

Beatriz M. DeJesus ◽

Adrielle A. Passos ◽

Lavínia Teixeira-Machado

Keyword(s):

Quality Of Life ◽

Autism Spectrum Disorder ◽

Down Syndrome ◽

Rating Scale ◽

Functional Independence Measure ◽

Functional Independence ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Children With Down Syndrome

This study investigated dance practice in psychosocial and functional aspects, and quality of life in children with Down syndrome and autism spectrum disorder. Children with DS and ASD, between 3 and 12 years old, attended a dance program during 16 sessions/lessons, lasting 60 min, twice a week, in suitable place. Functional Independence Measure (FIM), Childhood Autism Rating Scale SF-36 quality of life survey, and Knowledge, Attitude and Practice Inquiry (KAP Inquiry) were applied before and after dance classes. Eleven participants concluded the study. Functional independence changes were observed in relation to self-care, sphincter control, locomotion, and communication domains. Children’ “quality of life” reported by parents showed changes in functional capacity, vitality, mental health, physical and social aspects, and general state of health domains. These findings suggest that regular dance practice can underlie psychosocial adjustments in children with DS and ASD.

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