Article

PURPOSE: To assess the relationship between the Clock Drawing Test (CDT) and
rehabilitation outcome in hip fracture patients within normal range of the Mini
Mental State Examination (MMSE). This retrospective study was performed
in a post-acute geriatric rehabilitation centre. One hundred and forty-two
patients with proximal hip fracture admitted from January 2006 to June 2008 whose
MMSE scores was within normal range (>23) were enrolled in the study. The
patients were divided into two groups according to CDT performance (impaired
versus intact). The differences between the two groups in relation to age,
gender, education level, living arrangement, pre fracture functional level,
fracture type, and outcome measurements [Functional Independent Measure (FIM),
motor FIM, Rate of in-hospital Improvement (RI) in FIM and motor FIM, and Length
of Stay (LOS)] were assessed. RESULTS: Discharge FIM score and motor FIM scores
were significantly lower for the impaired CDT group (89 +/- 13.7 vs. 94.9 +/-
11.6, p = 0.007; 61.6 +/- 11.1 vs. 65.7 +/- 9.6, p = 0.022 respectively); LOS was
significantly longer (28.2 +/- 7.9 vs. 25.3 +/- 8.5, p = 0.033) and rates of
improvement in FIM and motor FIM were significantly slower (0.62 +/- 0.35 vs.
0.77 +/- 0.45, p = 0.036; 0.61 +/- 0.34 vs. 0.75 +/- 0.42, p = 0.033,
respectively). Nevertheless, FIM and motor FIM scores changes were similar in
both CDT groups. Following adjustment for age, LOS of patients with impaired CDT
was significantly longer
(p = .027). CONCLUSIONS:
The CDT may assist the
multidisciplinary team in identifying hip fracture patients whose MMSE scores are
within the normal range, but yet need a longer training period to extract their
rehabilitation potential.

Langue : ANGLAIS