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Citation
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Karlsson Å, Berggren M, Gustafson Y, Olofsson B, Lindelöf N, Stenvall M. J. Am. Med. Dir. Assoc. 2016; 17(5): 464.e9-464.e15. |
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Affiliation
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Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden. |
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Abstract
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OBJECTIVE: To evaluate if Geriatric Interdisciplinary Home Rehabilitation could improve walking ability for older people with hip fracture compared with conventional geriatric care and rehabilitation. A secondary aim was to investigate the postoperative length of hospital stay (LOS).
DESIGN: Randomized controlled trial. SETTING: Geriatric ward, ordinary housing, and residential care facilities. PARTICIPANTS: People operated on for a hip fracture (n = 205), aged 70 or older, including those with cognitive impairment, and living in the north of Sweden. INTERVENTION: Home rehabilitation with the aim of early hospital discharge that was individually designed and carried out by an interdisciplinary team for a maximum of 10 weeks. Special priority was given to prevention of falls, independence in daily activities, and walking ability both indoors and outdoors. MEASUREMENTS: Walking ability and the use of walking device was assessed in an interview during the hospital stay. These assessments were repeated along with gait speed measurements at 3- and 12-month follow-up. The length of the hospital stay after the hip fracture was recorded.
RESULTS: No significant differences were observed in walking ability, use of walking device, and gait speed at the 3- and 12-month follow-up between the groups. At 12 months, 56.3% of the intervention group and 57.7% of the control group had regained or improved their prefracture walking ability. The median postoperative LOS in the geriatric ward was 6 days shorter for the intervention group (P = .003).
CONCLUSION: Participants receiving Geriatric Interdisciplinary Home Rehabilitation regained walking ability in the short- and long-term similar to those receiving conventional geriatric care and rehabilitation according to a multifactorial rehabilitation program. The intervention group had a significantly shorter postoperative LOS in the hospital.
Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
Language: en |