Effects of rehabilitation therapy based on exercise prescription on motor function and complications after hip fracture surgery in elderly patients

Abstract

Background Exercise rehabilitation training is an important measure for improving the prognosis of patients with hip fractures. However, the particular program that works effectively and the efficiency of exercise therapy are still controversial. Objective To compare the effects of usual postoperative care combined with rehabilitation based on exercise prescription on motor function and complications in elderly patients who underwent surgery for hip fracture. Methods This was an observational study. A total of 71 elderly patients with hip fractures who were treated with hip arthroplasty and internal fixation of the proximal femur with an intramedullary nail at Suzhou Municipal Hospital from October 2020 to December 2021 were included; 11 cases were excluded (eight cases were excluded due to loss of follow-up, two due to deaths from other causes, and one due to other reasons). Finally, 60 patients (18 males and 42 females) were included. Patients were randomly assigned to the control (n = 30) and experimental (n = 30) groups using a random number generator. Patients in the control group received usual postoperative care, whereas those in the experimental group received usual postoperative care combined with rehabilitation training based on the principles of exercise prescription. We recorded the motor function (Harris hip score), daily living ability (Barthel Index), and complications at discharge and 1, 3, and 6 months postoperatively for statistical analysis. Results The Harris hip score and Barthel Index score were significantly higher at 1, 3, and 6 months postoperatively than at discharge in both groups (p < 0.05). The Harris hip score and Barthel Index score at discharge and 1, 3, and 6 months postoperatively were significantly higher in the experimental group than in the control group (p < 0.05). The incidence of complications at 6 months postoperatively was significantly lower in the experimental group than in the control group (13% vs. 37%). Conclusions Rehabilitation therapy based on exercise prescription helps improve hip function and the ability to perform activities of daily living and related postoperative complications after hip fracture surgery in elderly patients. The findings of our study will guide decision-making in clinical practice and improve the clinical management of hip fractures in elderly patients postoperatively.

Analysis of the clinical characteristics and risk factors associated with contralateral hip fracture after initial hip fracture in elderly patients: a retrospective cohort study

“…Patients with poor hip function after the first hip surgery, combined with lower limb muscle atrophy resulting from being bedridden for long periods, leading to poor muscle strength and ability to balance, as well as the coordination and function of the hip joint, were more prone to sustain contralateral hip fracture with a fall, which may be associated with a higher tendency for contralateral hip fracture occurrence within three years. Research has shown that postoperative muscle weakness around the hip is an important contributor to contralateral fracture after initial hip fracture surgery 12 , and early postoperative rehabilitation training can enhance hip muscle strength and improve hip joint mobility 13 . Therefore, improving both muscle strength and joint movement after initial hip-fracture surgery would be beneficial in preventing contralateral fracture.…”

Development of a Postoperative Rehabilitation Training Device for Patients with Upper and Lower Limb Muscular Atrophy

“…For patients with muscular atrophy, the elastic rope is broken when the rebound force is very easy to lead to the atrophy of the muscles by further impact and injury, and the conventional preventive mechanism will cause the human body to local joints or limbs of the region of the body to further over the rapid stretching, which leads to muscle strains, therefore causing a considerable safety problem. The existing rehabilitation equipment is too limited to be used for muscle building in joints such as the fingers and is prone to doctor-patient disputes (Che et al, 2023). Lower limb rehabilitation training occasionally occurs when the lower limbs suddenly do not make the situation, so easy to lead to the rebound force of the training device injury to the lower limbs, which is likely to increase the pain in the lower limbs.…”