Article

The purpose of this study is to characterize hip-fractured patients who
maintained or improved their functional ability, 1 year postdischarge from
rehabilitation and to identify factors associated with functional achievement
maintenance. METHODS: A retrospective study performed in a postacute geriatric
rehabilitation center. Two hundred thirty-three hip-fractured patients admitted
consecutively from January 2006 to September 2007 were enrolled in the study. The
patients were evaluated at discharge from rehabilitation and after 1 year, they
were classified into two groups: those who maintained or improved their motor
Functional Independence Measure (mFIM) scores and those who deteriorated. The
differences between the two patient groups relating to functional, clinical,
demographic and fracture-related variables were assessed. RESULTS: One year
postrehabilitation, 130 (55.8%) patients exhibited a decline in their mFIM score.
Patients whose 1-year mFIM score had improved were discharged from rehabilitation
with a less favorable mean mFIM score (50.7 +/- 18.5 vs. 55.6 +/- 15.2; p =
0.032), achieved a lower mean mFIM score gain during rehabilitation (12.0 +/- 9.7
vs. 14.6 +/- 8.1; p = 0.03), had a higher education level (p = 0.003) and had a
lower rate of chronic lung disease (p = 0.020) compared with patients whose
1-year mFIM score had deteriorated. After 1 year, only 21 patients (9%) were
functionally independent in activities of daily living and only 19 (8.2%) were
able to walk unassisted. Only 13 patients (5.6%) perceived that they had regained
their former functional level. CONCLUSIONS: A substantial decline in functional
ability of hip-fractured patients occurred 1 year postdischarge from rehabilitation. Healthcare providers should be aware of the necessity for a
long-term postrehabilitation physical training program to prevent functional
decline. Further efforts should be invested in motivating their patients to
exercise.

Langue : ANGLAIS