Get up and get moving—early mobilisation after hip fracture surgery

Sallehuddin, Hakimah; Ong, Terence

doi:10.1093/ageing/afaa241

Cited by 8 publications

(4 citation statements)

References 10 publications

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“…However, for patients who need early ground activities and start rehabilitation training as soon as possible, attention should be paid to preventing falls. Early ambulation on the day of operation or the next day is an important index of rehabilitation in patients with hip arthroplasty [ 19 , 20 ]. Using short-acting or low-concentration local anesthetics to realize FICB can prevent the decline of muscle strength, but it will also weaken postoperative analgesia.…”

Section: Discussionmentioning

confidence: 99%

Effect of perioperative ultrasound guided fascia iliaca compartment block in elderly adults with hip fractures undergoing arthroplasty in spinal anesthesia—a randomized controlled trial

et al. 2023

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Background For elderly adults undergoing hip arthroplasty, fascia iliaca compartment block (FICB) is often used before spinal anesthesia to reduce the pain of posture placement. However, the impact of FICB within 48 h needs further study. Methods 89 elderly adults scheduled to undergo arthroplasty for hip fracture were enrolled and randomized into the FICB group (n = 45) and the control group (n = 44). The fascia iliaca on the operated side was located using ultrasound, and a puncture needle was placed under the fascia iliaca. The FICB group was injected with 40 ml of 0.5% ropivacaine, and the control group was injected with 40 ml of normal saline. Spinal anesthesia was performed after 20 min. Our primary outcome measures were: duration of analgesia, muscle strength, and Quality of Recovery (QoR). Results The duration of analgesia in the FICB group was 403.5 ± 39.6 min, which was longer than that (357.5 ± 35.9 min) of the control group (P = 0.012). There were 19 (42.2%) patients with muscle strength of grade 4 in the FICB group and 36 (81.8%) patients with muscle strength of grade 4 in the control group. FICB group was lower (P < 0.001). QoR-15 at 24 h after surgery was 114.1 ± 8.3 in the FICB group and 104.6 ± 8.4 in the control group (P < 0.001). QoR-15 at 48 h after surgery was 122.7 ± 8.4 in the FICB group and 120.5 ± 9.5 in the control group (P = 0.232). Conclusions For elderly adults with hip fractures, FICB provided longer analgesia and improved 24-h QoR, but reduced postoperative muscle strength. Trail registration Chinese Clinical Registry Center, ChiCTR2200056937, 23/02/2022.

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Section: Discussionmentioning

confidence: 99%

Effect of perioperative ultrasound guided fascia iliaca compartment block in elderly adults with hip fractures undergoing arthroplasty in spinal anesthesia—a randomized controlled trial

et al. 2023

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“…By including all definitions of early mobilisation, and not restricting papers to those using the UK National Hip Fracture Database (NHFD) definition,7 we may be incorrectly highlighting the importance of some of these factors in relation to our specific question. The definition of what ‘early mobilisation’ entails needs further exploration in order to better measure this outcome 40…”

Section: Discussionmentioning

confidence: 99%

“…The definition of what ‘early mobilisation’ entails needs further exploration in order to better measure this outcome. 40 …”

Section: Discussionmentioning

confidence: 99%

What factors affect early mobilisation following hip fracture surgery: a scoping review

Gray,

Lacey,

Whitehouse

et al. 2023

BMJ Open Qual

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ObjectivesIdentify and evaluate factors affecting early mobilisation on the day following hip fracture surgery.DesignMixed methods, scoping review.Data sourcesMEDLINE, AMED, CINAHL, APA PsycINFO, APA PsycArticles, ISRCTN, Clinical Trials registry and grey literature accessed in November 2022 with publication dates between 2001 and November 2022.Eligibility criteriaEnglish language publications that:1. Include patient populations who sustain a fragility hip fracture managed surgically2. Include patient populations who are mobilised out of bed on the day following their hip fracture surgery3. Report factors which influence the ability to undergo early mobility postsurgeryData extraction and synthesisOne reviewer screened all titles and abstracts for inclusion. Two reviewers performed data extraction and quality assessments using the relevant Critical Appraisal Skills Programme tools and the Mixed Methods Appraisal Tool.Results3337 papers were identified, of which 23 studies were eligible for review, representing 210 811 patients. The heterogeneity in the types of study included, the definition of early mobilisation and the outcome measures used precluded meta-analysis. 13 factors were identified as having an effect on whether people were mobilised on day 1 post-hip fracture surgery, grouped into 5 principal themes: (1) healthcare setting or worker-related factors, (2) patient psychological factors, (3) acute patient health factors, (4) non-acute patient health factors and (5) surgical factors.ConclusionsThere was a paucity of robust research investigating day 1 mobilisation post-hip fracture surgery.Each of the five factors identified is potentially modifiable through service improvement change and innovation strategies. There is an opportunity to explore how service provision change could be implemented to improve outcomes for all patients following hip fracture surgery demonstrating the clinical and cost benefits of these changes against the cost of delivering the change.

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“…Due to the 24-hour nature of the profession, the nursing team plays an important role in providing patients with physical assistance for mobilisation to counter the effects of HAD. Mobilisation early in an admission is one of several recommendations to improve clinical outcomes in a number of acute conditions (ACSQHC, 2023;Bernhardt et al, 2015;Black et al, 2013;Freeman & Maley, 2013;Kapritsou et al, 2018;Mohanty et al, 2016;Sallehuddin & Ong, 2021). Increases in both structured and incidental mobilisation are associated with decreases in hospital length of stay (Oestergaard et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Teaching manual handling through risk assessment empowers the nursing team to provide safe mobility-related care: A qualitative analysis

Kugler,

Brusco,

Slade

et al. 2024

FoHPE

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Introduction: Mobilisation of hospital patients is important for their functioning, and nurses play an important role in providing assistance. Manual handling training programs aim to help nurses to move patients safely, but most do not include dynamic risk assessment. We aimed to explore the experiences of members of the nursing team working in inpatient wards in a private hospital who participated in the manual handling training program Risk Assessment for moving Individuals SafEly (RAISE). Methods: Members of the nursing team who attended a 4-hour dynamic risk assessment training program led by physiotherapists participated in one of two focus groups guided by semi-structured questions 4 months post training. Focus groups were facilitated by an experienced qualitative researcher (physiotherapist). Results: Three themes emerged: (1) empowerment, (2) role and (3) implementation. The training session improved the nurses’ confidence and empowerment to employ a risk assessment model for mobility-related care, which was central to their role. Organisational factors, including cluttered environments, equipment and staffing challenges, were identified as the key barriers to implementation. Conclusion: Risk assessment manual handling training was perceived to improve confidence and empower the nursing team to provide safe mobility-related care. It is recommended that training sessions be relatively short; provide refresher training and consistent access to training within departments across the target health service; and take into consideration organisational factors that may affect implementation.

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Get up and get moving—early mobilisation after hip fracture surgery

Cited by 8 publications

References 10 publications

Effect of perioperative ultrasound guided fascia iliaca compartment block in elderly adults with hip fractures undergoing arthroplasty in spinal anesthesia—a randomized controlled trial

Effect of perioperative ultrasound guided fascia iliaca compartment block in elderly adults with hip fractures undergoing arthroplasty in spinal anesthesia—a randomized controlled trial

What factors affect early mobilisation following hip fracture surgery: a scoping review

Teaching manual handling through risk assessment empowers the nursing team to provide safe mobility-related care: A qualitative analysis

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