Article

OBJECTIVE: To examine effects of physical and geriatric rehabilitation on
institutionalisation and mortality after hip fracture.
DESIGN: Prospective
randomised study. SETTING: Physically oriented (187 patients), geriatrically
oriented (171 patients), and health centre hospital rehabilitation (180 patients,
control group). SUBJECTS:
A total of 538 consecutively, independently living
patients with non-pathological hip fracture. MAIN MEASURES: Patients were
evaluated on admission, at 4 and 12 months for social status, residential status,
walking ability, use of walking aids, pain in the hip, activities of daily living
(ADL) and mortality. RESULTS: Mortality was significantly lower at 4 and 12
months in physical rehabilitation (3.2%, 8.6%) than in geriatric rehabilitation
group (9.6%, 18.7%, P=0.026, P=0.005, respectively) or control group (10.6%,
19.4%, P=0.006, P=0.004, respectively). At 4 months more patients in physical
(84.4%) and geriatric rehabilitation group (78.0%) were able to live at home or
sheltered housing than in control group (71.9%, P=0.0012 and P<0.001,
respectively). No significant difference was found between physical
rehabilitation and geriatric rehabilitation (P=0.278). Analysis of femoral neck
and trochanteric fractures showed that significant difference was true only for
femoral neck fractures (physical rehabilitation vs geriatric rehabilitation
P=0.308, physical rehabilitation vs control group P<0,001 and geriatric
rehabilitation vs control group P<0.001). Effects of intensified rehabilitations
disappeared at 12 months. No impact on walking ability or ADL functions was
observed. CONCLUSIONS: Physical rehabilitation reduced mortality. Physical and
geriatric rehabilitation significantly improved the ability of independent living
after 4 months especially among the femoral neck fracture patients but this
effect could not be seen after 12 months.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS