Authors (including presenting author) :
Mak HY (1), Ho CM (1), Kwok WC (1), Leung SK (1), Wong WC (1), Tsui SKA (1)
Affiliation :
(1) Physiotherapy Department, TWGHs Wong Tai Sin Hospital
Keyword 1: :
Hip fracture
Keyword 2: :
Rehabilitation
Keyword 3: :
Prospective cohort study
Keyword 4: :
Post-operation
Keyword 5: :
Hip strength
Introduction :
Hip fracture presents a major global healthcare challenge due to high morbidity, mortality, and cost. With an aging population, cases are projected to reach 4.5 million worldwide by 2050. Rehabilitation outcomes have traditionally focused on pain and mobility. Emerging evidence indicates that muscle strength and physical performance are important predictors of clinically adverse events and functional recovery in older adults post-fracture.
Objectives :
This study aimed to: 1) Identify changes in clinical characteristics (mobility, pain intensity, muscle strength, joint range of motion) of hip fracture patients following a post-operative rehabilitation program, and 2) Evaluate the feasibility of the study procedure.
Methodology :
Post-operative hip fracture patients under full weightbearing status in the Musculoskeletal Rehabilitation Program at TWGHs Wong Tai Sin Hospital were recruited using convenience sampling. Any patients with a history of previous hip fractures, any medical conditions that limits patient’s hip and knee joint range, and incompliance to rehabilitation are excluded. Patients received standard physiotherapy (strengthening, endurance, mobility training). Assessments using the Elderly Mobility Scale, Visual Analogue Scale, Handheld Dynamometry, and Joint Goniometry were conducted upon patients’ entry of the program and by the end of it.
Result & Outcome :
In total, 17 patients consented and were enrolled. Retention was 16 / 17 (94.1%) with one participant transferred to an acute hospital due to unrelated medical condition. No adverse events occurred during the assessments.
The cohort (n = 17) has an average age of 85.2 and a median score of 4.8 in the Charlson Comorbidity Index. Of the 17 participants, 10 received gamma nail fixation while 7 received hemiarthroplasty. Related-samples Wilcoxon Signed Rank Test was done, and significant improvements were noted on mobility, pain intensity, hip strength, knee strength, hip joint range, and knee joint range (Z = 3.417, -3.413, 3.387, 2.8485, 3.3536, 2.552; all p < 0.05). Pain intensity, handgrip strength, knee extension strength, and hip abduction range showed significant Spearman’s Correlations with gait speed (r = -0.616, 0.652, 0.691, and 0.635, respectively; all p < 0.05). Simple linear regression was conducted to predict gait speed based on knee extension strength. Result shows that better knee extension strength results in better gait speed (β = 0.033; p = 0.013; VIF = 1.00).
