With the innovation of healthcare delivery systems, a need for early determination of patients' discharge outcomes arises after proximal femur fracture surgery, to reduce the burden on healthcare infrastructure. Several studies have examined the extent of walking ability early in the postoperative period to predict the outcome destination. In this study, as an additional validation of these studies, we examined the effect of walking ability on the hospital discharge prognosis of patients in the first week after proximal femur fracture surgery in Japan. [Participants and Methods] Medical records of 228 patients with proximal femur fractures, aged ≥75 years old, admitted between April 2015 and March 2019, were retrospectively analyzed. The objective variable was discharge destination. The main evaluation factor was walking ability one-week post-surgery. [Results] Good walking ability and the company of a relative living together one week post-surgery were significant determining factors of discharge destination. [Conclusion] The ability to walk and the presence of a co-resident one week after surgery increased the likelihood of proximal femur fracture patients to be discharged directly to home. Our findings may help rehabilitation professionals make better decisions regarding discharge destination.

Background: Patients with nervous system and musculoskeletal diseases display gait disturbance that is a leading cause of falls. Identification of disease-specific movement hallmarks is therefore an essential first step in preventing falls. Since turning, a common daily activity, is a unique movement that requires inter-limb spatial coordination, turning may be a suitable observational target for the identification of disease-specific movement disorder. However, to date, few comprehensive systematic review regarding disease-specific alterations in turning movement is available. Research question: This systematic review with meta-analysis summarized the level of knowledge regarding movement disorders during turning in patients with nervous system and musculoskeletal diseases. Methods: A systematic review was conducted of papers throughout 2021 in accordance with PRISMA guideline. Including criteria were (1) were published in a peer-reviewed journal, (2) were written in English, (3) included adult patients who were diagnosed with musculoskeletal or nervous system diseases, (4) had a control group of age-matched healthy adults, and (5) outcomes included turning parameters. Results: Meta-analysis revealed a significantly larger step number, longer turn duration, and shorter step length in patients with Parkinson's disease (PD) than in controls during the 180 degree turn, suggesting that these biomechanical alterations may be, at least in part, movement disorders associated with PD. Notably, this review identified methodological heterogeneity for turning movement assessments, which limited the identification of disease-specific movement disorders. Significance: This work serves as a call to action for the establishment of a standard assessment protocol towards the identification of disease-specific turning movement disorders and effective disease screening.