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hip fracture rehabilitation

J T Schousboe, M L Paudel, B C Taylor, A M Kats, B A Virnig, B E Dowd, L Langsetmo, K E Ensrud
: Older women with pre-fracture slow walk speed, high body mass index, and/or a high level of multimorbidity have significantly higher health care costs after hip fracture compared to those without those characteristics. Studies to investigate if targeted health care interventions for these individuals can reduce hip fracture costs are warranted. INTRODUCTION: The aim of this study is to estimate the associations of individual pre-fracture characteristics with total health care costs after hip fracture, using Study of Osteoporotic Fractures (SOF) cohort data linked to Medicare claims...
October 14, 2016: Osteoporosis International
Jose Ramón Caeiro, Agustí Bartra, Manuel Mesa-Ramos, Íñigo Etxebarría, Jorge Montejo, Pedro Carpintero, Francesc Sorio, Sonia Gatell, Andrea Farré, Laura Canals
The purpose of this study was to estimate the burden of osteoporotic fractures beyond the hospitalization period covering up to the first year after the fracture. This was a prospective, 12-month, observational study including patients aged ≥65 years hospitalized due to a first low-trauma hip fracture, in six Spanish regions. Health resource utilization (HRU), quality of life (QoL) and autonomy were collected and total costs calculated. Four hundred and eighty seven patients (mean ± SD age 83 ± 7 years, 77 % women) were included...
October 14, 2016: Calcified Tissue International
Bayram Unver, Refik Hilmi Baris, Ertugrul Yuksel, Senol Cekmece, Serpil Kalkan, Vasfi Karatosun
PURPOSE: To investigate the test-retest reliability of the 4-meter walk test (4 MWT) and 10-meter walk test (10 MWT) in patients undergoing lower extremity surgery during inpatient rehabilitation. METHOD: In all, 102 patients with total hip arthroplasty (THA), total knee arthroplasty (TKA), lower extremity fracture (LEF) and soft tissue operation were recruited. Patients performed two 4 MWT and two 10 MWT trials on the same day. The same researcher performed all the measurements to avoid inter-rater variability...
October 11, 2016: Disability and Rehabilitation
Nefyn H Williams, Jessica L Roberts, Nafees Ud Din, Nicola Totton, Joanna M Charles, Claire A Hawkes, Val Morrison, Zoe Hoare, Michelle Williams, Aaron W Pritchard, Swapna Alexander, Andrew Lemmey, Robert T Woods, Catherine Sackley, Pip Logan, Rhiannon T Edwards, Clare Wilkinson
OBJECTIVE: To conduct a rigorous feasibility study for a future definitive parallel-group randomised controlled trial (RCT) and economic evaluation of an enhanced rehabilitation package for hip fracture. SETTING: Recruitment from 3 acute hospitals in North Wales. Intervention delivery in the community. PARTICIPANTS: Older adults (aged ≥65) who received surgical treatment for hip fracture, lived independently prior to fracture, had mental capacity (assessed by clinical team) and received rehabilitation in the North Wales area...
October 5, 2016: BMJ Open
Shabnam Samsami, Sadegh Saberi, Nima Bagheri, Gholamreza Rouhi
BACKGROUND: Vertical femoral neck fractures in the youth could be happened in high-energy accidents, and because of dominant shearing forces, this fracture is considered as a troublesome injury with a controversy regarding selection of the best fixation method. OBJECTIVE: The long term goal of this quasi-experimental study was to find the more stable fixation method among cannulated screws (CSs), proximal femoral locking plate (PFLP), and dynamic hip screw with derotational screw (DHS+DS) for this kind of fracture...
September 28, 2016: Bio-medical Materials and Engineering
E Shanahan, C Henderson, A Butler, B Lenehan, T Sheehy, A Costelloe, S Carew, C Peters, M O'Connor, D Lyons, J Ryan
Hip fracture is common in older adults and is associated with high morbidity, mortality and significant health care costs. A pilot orthogeriatrics service was established in an acute hospital. We aimed to establish the cost effectiveness of this service. Length of hospital stay, discharge destination and rehabilitation requirements were analysed for a one year period and compared to patients who received usual care prior to the service. We calculated the costs incurred and savings produced by the orthogeriatric service...
2016: Irish Medical Journal
G A A Rebagliati, L Sciumè, P Iannello, A Mottini, A Antonietti, V A Caserta, V Gattoronchieri, Lorenzo Panella, Camilla Callegari
Hip fracture is common in the elderly and it is usually associated with comorbidities and physiological changes which may have an impact on functioning and quality of life. The concept of resilience may explain why this impact varies among patients. The aim of this open, prospective cohort study was to explore the relationships between resilience, frailty and quality of life in orthopedic rehabilitation patients, and also to assess whether these factors might affect rehabilitation outcome. Eighty-one patients, older than 60 years, underwent a multidisciplinary assessment at the beginning and at the end of the rehabilitation period following orthopedic surgery to the lower limb...
July 2016: Functional Neurology
Avital Hershkovitz, Natalia Kornyukov, Shai Brill
PURPOSE: The study aimed at assessing the relationship between various Mini Mental State Examination (MMSE) subdomains and rehabilitation achievements in post-acute hip-fractured patients. METHOD: Six hundred and five hip-fractured patients admitted during 2010-2013 to a post-acute geriatric rehabilitation center were included in the study. Main outcome measures were the Functional Independence Measure (FIM) instrument, the motor FIM (mFIM), the Montebello Rehabilitation Factor Score (MRFS) on the mFIM and length of stay (LOS)...
September 27, 2016: Disability and Rehabilitation
Anouk D Kabboord, Monica van Eijk, Marta Fiocco, Romke van Balen, Wilco P Achterberg
BACKGROUND: A well-grounded functional prognosis during triage for rehabilitation is important, especially in older patients who experience the burden of comorbidity. However, it remains unclear what impact comorbidity has on functional outcome after rehabilitation. AIM: To investigate the associations between comorbidity indexes and functional outcome after inpatient stroke or hip fracture rehabilitation. Furthermore, to identify which method of comorbidity assessment best reveals this relationship...
September 20, 2016: Journal of the American Medical Directors Association
Krisztina Juhász, Béla Turchányi, Tibor Mintál, Péter Somogyi
Hip fractures are described by increased mortality, loss of quality of life, functional decline and burden of diseases. They show a growing number worldwide. The aim of the present study is to summarise the existing data on the incidence, mortality, complications and rehabilitation of hip fractures, which relevance is reported only by few studies. To reduce mortality and complications of hip fractures the authors emphasize the importance of primary treatment within 12 hours, appropriate selection of surgical methods corresponding to the fracture type after the assessment of femoral head viability, vitamin D supplementation, same conditions for primary treatment during everyday of the week, and an adequate acute treatment and rehabilitation for patient's general health status...
September 2016: Orvosi Hetilap
Tatsuro Inoue, Syogo Misu, Toshiaki Tanaka, Hiroki Sakamoto, Kentaro Iwata, Yuki Chuman, Rei Ono
BACKGROUND & AIMS: Malnutrition is common in patients with hip fractures, and elderly patients with hip fractures lose functional independence and often fail to recover previous functional status. The aim of this study was to determine whether pre-fracture nutritional status predicts functional status of patients with hip fracture at discharge from acute hospitals. METHODS: In the present multicenter prospective cohort study, pre-fracture nutritional status was assessed using the Mini Nutritional Assessment Short-Form (MNA-SF)...
August 31, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Pia Kjaer Kristensen, Theis Muncholm Thillemann, Kjeld Søballe, Søren Paaske Johnsen
OBJECTIVES: To examine the association between process performance measures and clinical outcome among patients with hip fracture. DESIGN: Nationwide, population-based follow-up study. SETTING: Public Danish hospitals. PARTICIPANTS: A total of 25 354 patients 65 years or older who were admitted with a hip fracture in Denmark between 2010 and 2013. INTERVENTION: The process performance measures, including systematic pain assessment, early mobilization, basic mobility assessment at arrival and at discharge, post-discharge rehabilitation program, anti-osteoporotic medication and prevention of future fall accidents measures, were analysed individually as well as an opportunity-based score defined as the proportion of all relevant performance measures fulfilled for the individual patient (0-50%, 50-75% and 75-100%)...
September 2, 2016: International Journal for Quality in Health Care
Suzanne M Dyer, Maria Crotty, Nicola Fairhall, Jay Magaziner, Lauren A Beaupre, Ian D Cameron, Catherine Sherrington
BACKGROUND: Hip fractures are an increasingly common consequence of falls in older people that are associated with a high risk of death and reduced function. This review aims to quantify the impact of hip fracture on older people's abilities and quality of life over the long term. METHODS: Studies were identified through PubMed and Scopus searches and contact with experts. Cohort studies of hip fracture patients reporting outcomes 3 months post-fracture or longer were included for review...
2016: BMC Geriatrics
Marco Monticone, Emilia Ambrosini, Claudio Secci, Barbara Rocca, Simona Ferrante, Antonio Capone
OBJECTIVE: To evaluate the responsiveness and minimal important changes (MICs) for the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and its subscales in subjects with hip fractures. DESIGN: At the beginning and end of a 2-month rehabilitation program, 106 patients completed the WOMAC. After the program, the global perceived effect (GPE) was analyzed to produce a dichotomous outcome (improved vs. stable). Responsiveness for the WOMAC and its subscales were calculated by distribution (effect size; standardized response mean) and anchor-based methods (receiver operating characteristic curves; correlations between change scores of the WOMAC and its subscales and GPE)...
August 31, 2016: American Journal of Physical Medicine & Rehabilitation
C Gatot, A Cc Chou, T S Howe, W Yeo, H C Chong, J Sb Koh
PURPOSE: To identify predictors for rehabilitation outcome in Asian geriatric hip fracture patients. METHODS: Records of 153 consecutive Asian patients aged 61 to 99 years who underwent surgery for hip fracture and were followed up for at least one year were reviewed. They were stratified into 4 agegroups: 60-69 years (n=27), 70-79 years (n=70), 80-89 years (n=50), and ≥90 years (n=6). Any comorbidity, regardless of severity, was recorded. Pre-injury and postoperative functional status was evaluated using the 36-item Short Form Health Survey...
August 2016: Journal of Orthopaedic Surgery
Jeffrey C Munson, Julie P W Bynum, John-Erik Bell, Robert Cantu, Christine McDonough, Qianfei Wang, Tor D Tosteson, Anna N A Tosteson
Importance: Patients who have a fragility fracture are at high risk for subsequent fractures. Prescription drugs represent 1 factor that could be modified to reduce the risk of subsequent fracture. Objective: To describe the use of prescription drugs associated with fracture risk before and after fragility fracture. Design, Setting, and Participants: Retrospective cohort study conducted between February 2015 and March 2016 using a 40% random sample of Medicare beneficiaries from 2007 through 2011 in general communities throughout the United States...
October 1, 2016: JAMA Internal Medicine
Bong-Ju Park, Hong-Man Cho, Woong-Bae Min
PURPOSE: People with dementia have poor mobility and discharge outcomes following hip fractures. The purpose of this study was to evaluate the clinical and radiological results of internal fixation of undisplaced femur neck fractures (Garden types 1 and 2) by proximal femoral nail antirotation (PFNA) in dementia patients. MATERIALS AND METHODS: We studied retrospectively 19 patients with undisplaced femur neck fracture. All patients were over 70 years of age, walked independently with a cane or crutches and suffered moderate-to-severe dementia...
September 2015: Hip Pelvis
Maggie Killington, Ruth Walker, Maria Crotty
PURPOSE OF THE STUDY: To understand the journey experienced by nursing home residents following hip fracture and impressions of an outreach rehabilitation program offered after their return home. DESIGN AND METHODS: A qualitative investigation was undertaken in parallel with a randomised controlled trial investigating the efficacy and cost utility of providing a hospital outreach rehabilitation program for older nursing home residents who have recently returned from hospital following hip fracture...
November 2016: Archives of Gerontology and Geriatrics
Lene Lindberg, Wilhelmina Ekström, Margareta Hedström, Lena Flodin, Susanne Löfgren, Leif Ryd
Different rehabilitation programs after surgery have been presented to improve the outcome for patients with a hip fracture. Empowerment has been suggested as useful, but requires a change in the caring behaviours of health professionals. The aim with this study was to evaluate if training and supervision of the nursing staff could alter caring behaviours. A case-control study of nursing staff treating hip fracture patients was performed at a hospital with two sites. Training and supervision was given to the nursing staff at the intervention site...
July 29, 2016: Psychology, Health & Medicine
Anthony W Ireland, Patrick J Kelly, Robert G Cumming
Objective Hospital management of hip fracture varies widely with regard to length of stay, delivery of post-surgical care and costs. The present study compares the association between hospital utilisation and costs and patient outcomes in the six Australian states. Methods The present study was a retrospective cohort study of linked administrative databases for 2530 Australian veterans and war widows aged ≥65 years, hospitalised for hip fracture in 2008-09. Department of Veterans' Affairs datasets for hospital episodes, residential aged care admissions and date of death were linked...
April 2016: Australian Health Review: a Publication of the Australian Hospital Association
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