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Early coordinated rehabilitation in acute phase after hip fracture – a model for increased patient participation
BACKGROUND: Studies have shown that patients with hip fracture treated in a Comprehensive Geriatric Care (CGC) unit report better results in comparison to orthopaedic care. Furthermore, involving patients in their healthcare by encouraging patient participation can result in better quality of care a...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5646112/ https://www.ncbi.nlm.nih.gov/pubmed/29041916 http://dx.doi.org/10.1186/s12877-017-0640-z |
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author | Asplin, Gillian Carlsson, Gunnel Zidén, Lena Kjellby-Wendt, Gunilla |
author_facet | Asplin, Gillian Carlsson, Gunnel Zidén, Lena Kjellby-Wendt, Gunilla |
author_sort | Asplin, Gillian |
collection | PubMed |
description | BACKGROUND: Studies have shown that patients with hip fracture treated in a Comprehensive Geriatric Care (CGC) unit report better results in comparison to orthopaedic care. Furthermore, involving patients in their healthcare by encouraging patient participation can result in better quality of care and improved outcomes. To our knowledge no study has been performed comparing rehabilitation programmes within a CGC unit during the acute phase after hip fracture with focus on improving patients’ perceived participation and subsequent effect on patients’ function. METHODS: A prospective, controlled, intervention performed in a CGC unit and compared with standard care. A total of 126 patients with hip fracture were recruited who were prior to fracture; community dwelling, mobile indoors and independent in personal care. Intervention Group (IG): 63 patients, mean age 82.0 years and Control Group (CG): 63 patients mean age 80.5 years. Intervention: coordinated rehabilitation programme with early onset of patient participation and intensified occupational therapy and physiotherapy after hip fracture surgery. The primary outcome measure was self-reported patient participation at discharge. Secondary outcome measures were: TLS-BasicADL; Bergs Balance Scale (BBS); Falls Efficacy Scale FES(S); Short Physical Performance Battery (SPPB) and Timed Up and Go (TUG) at discharge and 1 month and ADL staircase for instrumental ADL at 1 month. RESULTS: At discharge a statistically significant greater number of patients in the IG reported higher levels of participation (p < 0.05) and independence in lower body hygiene (p < 0.05) and dressing (p < 0.001). There were however no statistically significant differences at discharge and 1 month between groups in functional balance and confidence, performance measures or risk for falls. CONCLUSION: This model of OT and PT coordinated inpatient rehabilitation had a positive effect on patients’ perceived participation in their rehabilitation and ADL at discharge but did not appear to affect level of recovery or risk for future falls at 1 month. A large proportion of patients remained at risk for future falls at 1 month in both groups highlighting the need for continued rehabilitation after discharge. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03301584 (Retrospectively registered: 4(th) October 2017). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-017-0640-z) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5646112 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-56461122017-10-26 Early coordinated rehabilitation in acute phase after hip fracture – a model for increased patient participation Asplin, Gillian Carlsson, Gunnel Zidén, Lena Kjellby-Wendt, Gunilla BMC Geriatr Research Article BACKGROUND: Studies have shown that patients with hip fracture treated in a Comprehensive Geriatric Care (CGC) unit report better results in comparison to orthopaedic care. Furthermore, involving patients in their healthcare by encouraging patient participation can result in better quality of care and improved outcomes. To our knowledge no study has been performed comparing rehabilitation programmes within a CGC unit during the acute phase after hip fracture with focus on improving patients’ perceived participation and subsequent effect on patients’ function. METHODS: A prospective, controlled, intervention performed in a CGC unit and compared with standard care. A total of 126 patients with hip fracture were recruited who were prior to fracture; community dwelling, mobile indoors and independent in personal care. Intervention Group (IG): 63 patients, mean age 82.0 years and Control Group (CG): 63 patients mean age 80.5 years. Intervention: coordinated rehabilitation programme with early onset of patient participation and intensified occupational therapy and physiotherapy after hip fracture surgery. The primary outcome measure was self-reported patient participation at discharge. Secondary outcome measures were: TLS-BasicADL; Bergs Balance Scale (BBS); Falls Efficacy Scale FES(S); Short Physical Performance Battery (SPPB) and Timed Up and Go (TUG) at discharge and 1 month and ADL staircase for instrumental ADL at 1 month. RESULTS: At discharge a statistically significant greater number of patients in the IG reported higher levels of participation (p < 0.05) and independence in lower body hygiene (p < 0.05) and dressing (p < 0.001). There were however no statistically significant differences at discharge and 1 month between groups in functional balance and confidence, performance measures or risk for falls. CONCLUSION: This model of OT and PT coordinated inpatient rehabilitation had a positive effect on patients’ perceived participation in their rehabilitation and ADL at discharge but did not appear to affect level of recovery or risk for future falls at 1 month. A large proportion of patients remained at risk for future falls at 1 month in both groups highlighting the need for continued rehabilitation after discharge. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03301584 (Retrospectively registered: 4(th) October 2017). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-017-0640-z) contains supplementary material, which is available to authorized users. BioMed Central 2017-10-17 /pmc/articles/PMC5646112/ /pubmed/29041916 http://dx.doi.org/10.1186/s12877-017-0640-z Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Asplin, Gillian Carlsson, Gunnel Zidén, Lena Kjellby-Wendt, Gunilla Early coordinated rehabilitation in acute phase after hip fracture – a model for increased patient participation |
title | Early coordinated rehabilitation in acute phase after hip fracture – a model for increased patient participation |
title_full | Early coordinated rehabilitation in acute phase after hip fracture – a model for increased patient participation |
title_fullStr | Early coordinated rehabilitation in acute phase after hip fracture – a model for increased patient participation |
title_full_unstemmed | Early coordinated rehabilitation in acute phase after hip fracture – a model for increased patient participation |
title_short | Early coordinated rehabilitation in acute phase after hip fracture – a model for increased patient participation |
title_sort | early coordinated rehabilitation in acute phase after hip fracture – a model for increased patient participation |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5646112/ https://www.ncbi.nlm.nih.gov/pubmed/29041916 http://dx.doi.org/10.1186/s12877-017-0640-z |
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