Intensive In-Hospital Rehabilitation After Hip Fracture Surgery and Activities of Daily Living in Patients With Dementia: Retrospective Analysis of a Nationwide Inpatient Database

Uda, Kazuaki; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo

doi:10.1016/j.apmr.2019.06.019

Cited by 23 publications

(18 citation statements)

References 22 publications

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“…However, in the current study, only 20% of patients received physiotherapy on 6-7 out of a possible 7 days in the first postoperative week. This is similar to other international studies which noted 13% of patients received physiotherapy on 6-7 of a maximum 7 days a week (Japan) [32], physiotherapy input on a median of 5 days (Australia) [33], or daily until day 3 postoperatively and weekdays thereafter (Denmark) [34].…”

Section: Discussionsupporting

confidence: 90%

The impact of the frequency, duration and type of physiotherapy on discharge after hip fracture surgery: a secondary analysis of UK national linked audit data

et al. 2021

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Section: Discussionsupporting

confidence: 90%

The impact of the frequency, duration and type of physiotherapy on discharge after hip fracture surgery: a secondary analysis of UK national linked audit data

et al. 2021

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“…The patient’s dementia level was evaluated using the scale originally developed by the Japanese Ministry of Health, Labour, and Welfare that was used in a previous study. 11 ) The validity and reliability of dementia level detection were confirmed previously. 23 ) On the basis of a previous study, 11 ) we calculated the frequency of in-hospital rehabilitation treatment sessions (≤3.0, 3.1–4.0, 4.1–5.0, 5.1–6.0, or 6.1–7.0 days per week) and the intensity (average daily time) of in-hospital rehabilitation treatment (20–39, 40–59, or ≥60 min/day).…”

Section: Methodssupporting

confidence: 67%

“…The following variables were considered as covariates and were adjusted for in the analysis: age, sex, site of fracture (thoracic vertebra, lumbar vertebra, or both), BI score at admission, frequency of in-hospital rehabilitation treatments, intensity of in-hospital rehabilitation treatments, Charlson comorbidity index score, 22 ) residence before admission (home or nursing facility), body mass index (BMI) at admission (<18.5, 18.5–24.9, 25.0–29.9, or ≥30.0 kg/m 2 ), use of home health care services before admission (yes or no), level of dementia (no dementia, mild to moderate dementia, or severe dementia), 11 ) length of hospital stay, and admission by ambulance.…”

Section: Methodsmentioning

confidence: 99%

“…Early rehabilitation treatment is widely recommended and offered to patients with various orthopedic diseases in acute-care hospitals. 6 , 7 , 8 ) Based on previous studies, early rehabilitation treatment is deemed effective in reducing the length of hospital stay, 9 ) the risk of complications, 9 , 10 ) and in improving activities of daily living (ADL) 11 ) among patients undergoing surgical treatment. Moreover, early rehabilitation treatment is a key component of conservative treatment for patients with vertebral compression fractures.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Early Rehabilitation Treatment on Activities of Daily Living in Patients Receiving Conservative Treatment for Vertebral Compression Fracture

Ikeda

Suzuki

Takagi

et al. 2021

PRM

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Objectives : Vertebral compression fractures are common among older people. Currently, knowledge of the effects of early rehabilitation treatment on the recovery of activities of daily living (ADL) in older patients who receive conservative treatment for these fractures is limited. Using the instrumental variable (IV) method, we examined the effects on ADL at discharge of a delay in initiating rehabilitation treatment. Methods: In this retrospective cohort study, data from the Japanese Diagnosis Procedure Combination database were analyzed. The subjects were patients with vertebral compression fracture who had undergone rehabilitation treatment during their hospitalization between 2014 and 2019 in one of the 29 acute-care hospitals in Yamagata Prefecture. We analyzed data from 1706 patients (mean age, 82.1 years). The independent variable was the number of days between hospital admission and the start of rehabilitation treatment, and the outcome was the Barthel index (BI) score at discharge. An IV method was applied, with adjustments for covariates, including demographics and functional status at admission. Results: Most patients started rehabilitation treatment within 3 days of hospital admission. Our IV method showed that the interval between hospital admission and the start of rehabilitation treatment was significantly associated with the BI score at discharge. The coefficient was −2.71 (95% confidence interval [CI]: −5.06 to −0.35). Conclusions: A delay in initiating rehabilitation treatment had a negative effect on ADL at discharge. This result emphasizes the importance of including early rehabilitation treatment in acute care, as recommended by several existing guidelines for the treatment of orthopedic diseases.

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“…The National Institute for Health and Clinical Excellence (NICE) guidelines recommends “[e]arly identification of individual goals for multidisciplinary rehabilitation to recover mobility and independence, and to facilitate the return of patients to their ’pre-fracture‘ residence and to long term wellbeing” [ 7 ]. Evidence suggests that intensive in-hospital [ 8 ] and outpatient/home rehabilitation [ 9 ] of post-hip-fracture surgical patients is associated with greater improvements in physical function and the activities of daily living. A recent meta-analysis identified that exercise interventions, provided in the early phase of hip-fracture rehabilitation, in older adults, can improve physical function.…”

Section: Introductionmentioning

confidence: 99%

Effect of Individual Nutrition Therapy and Exercise Regime on Gait Speed, Physical Function, Strength and Balance, Body Composition, Energy and Protein, in Injured, Vulnerable Elderly: A Multisite Randomized Controlled Trial (INTERACTIVE)

et al. 2021

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It is imperative that the surgical treatment of hip fractures is followed up with rehabilitation to enhance recovery and quality of life. This randomized controlled trial aimed to determine if an individualised, combined exercise–nutrition intervention significantly improved health outcomes in older adults, after proximal femoral fracture. We commenced the community extended therapy while in hospital, within two weeks post-surgery. The primary outcome was gait speed and secondary outcomes included physical function, strength and balance, body composition, energy and protein intake. Eighty-six and 89 participants were randomized into six months individualised exercise and nutrition intervention and attention-control groups, respectively. There were no statistically significant differences in gait speed between the groups at six and 12 months. There were no major differences between groups with respect to the secondary outcomes, except estimated energy and protein intake. This may be explained by the sample size achieved. Participants in the intervention group had greater increment in energy (235 kcal; 95% CI, 95 to 375; p = 0.01) and protein intake (9.1 g; 95% CI, 1.5 to 16.8; p = 0.02), compared with those in the control group at six months but not significant at 12 months. This study has demonstrated that providing early, combined exercise and nutrition therapy can improve dietary energy and protein intake in older adults with hip fractures.

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Intensive In-Hospital Rehabilitation After Hip Fracture Surgery and Activities of Daily Living in Patients With Dementia: Retrospective Analysis of a Nationwide Inpatient Database

Cited by 23 publications

References 22 publications

The impact of the frequency, duration and type of physiotherapy on discharge after hip fracture surgery: a secondary analysis of UK national linked audit data

The impact of the frequency, duration and type of physiotherapy on discharge after hip fracture surgery: a secondary analysis of UK national linked audit data

Effect of Early Rehabilitation Treatment on Activities of Daily Living in Patients Receiving Conservative Treatment for Vertebral Compression Fracture

Effect of Individual Nutrition Therapy and Exercise Regime on Gait Speed, Physical Function, Strength and Balance, Body Composition, Energy and Protein, in Injured, Vulnerable Elderly: A Multisite Randomized Controlled Trial (INTERACTIVE)

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