Journal of the American Geriatrics Society · 2005 · 143 citations · 32 references
MedicineOrthopedic SurgeryRehabilitation MedicineGeriatricsGerontologyRehabilitationComprehensive Geriatric AssessmentFracture RehabilitationFunctional Assessment In Older AdultsGeriatric Physical TherapyHip RehabilitationPost-fracture RehabilitationGeriatric Fracture RehabilitationHealth Outcomes AnalysisHip Fracture RecoveryInterdisciplinary Geriatric CareInterprofessional Discharge PlanningPhysical Function AssessmentPhysical Function MeasurementPostoperative Hip Rehabilitation
OBJECTIVES: To evaluate an interdisciplinary intervention program for older people with hip fracture in Taiwan. DESIGN: Randomized experimental design. SETTING: A 3,800-bed medical center in northern Taiwan. PARTICIPANTS: Elderly patients with hip fracture (N=137) were randomly assigned to an experimental (n=68) or control (n=69) group. INTERVENTION: An interdisciplinary program of geriatric consultation, continuous rehabilitation, and discharge planning. MEASUREMENTS: Demographic and outcome variables were measured. Outcome variables included service utilization, clinical outcomes, self-care abilities, health-related quality-of-life (HRQOL) outcomes, and depressive symptoms. RESULTS: Subjects in the experimental group improved significantly more than those in the control group in the following outcomes: ratio of hip flexion 1 month after discharge (P=.02), recovery of previous walking ability at 1 month (P=.04) and 3 months (P=.001) after discharge, and activities of daily living at 1 month (P=.01) and 2 months (P=.001) after discharge. Three months after discharge, the experimental group showed significant improvement in peak force of the fractured limb's quadriceps (P=.04) and the following health outcomes: bodily pain (P=.03), vitality (P<.001), mental health (P=.02), physical function (P<.001), and role physical (P=.006). They also had fewer depressive symptoms (P=.008) 3 months after discharge. CONCLUSION: This intervention program may benefit older people with hip fractures in Taiwan by improving their clinical outcomes, self-care abilities, and HRQOL and by decreasing depressive symptoms within 3 months after discharge.
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