Gender differences in recovery from injuries to the extremities in older persons. A prospective study.
OBJECTIVE
This paper examines gender differences in trajectories of basic activities of daily living after fall-related injuries to the extremities in independently living older people in the Netherlands.


METHODS
The study comprised a prospective design. Data were collected from 31 men and 140 women at baseline, when they had not yet sustained injuries (hip fractures, other fractures or contortions and dislocations), and 8 weeks, 5 months and 12 months after their accident. Analysis of variance was used to test for differences in change in basic activities of daily living between baseline and follow-ups for men, for women and for the total study sample while adjusting for several covariates.


RESULTS
The patients did not generally regain their pre-injury levels of functioning 12 months after their event. However, in contrast to the women, older men more closely reached their pre-injury levels of functioning. Although women deteriorated more than men, differences were not statistically significant at 8 weeks and 5 months post-injury. Long-term recovery, however, was significantly associated with gender when the impact of severity seemed to have expired.


CONCLUSIONS
Recovery of basic activities of daily living one year after injuries to the extremities seems to be influenced by gender. Female patients recovered less well compared to males. These gender-related changes warrant concern and attention in clinical practice.
Kempen
G I J M
GI
Department of Health Care Studies, Section of Medical Sociology, Maastricht University, Maastricht, The Netherlands. g.kempen@zw.unimaas.nl
Sanderman
R
R
Scaf-Klomp
W
W
Ormel
J
J
D000058:Accidental Falls; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001134:Arm Injuries / Q000175:diagnosis / Q000534:rehabilitation* / Q000601:surgery; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis / Q000534:rehabilitation* / Q000601:surgery; D015577:Geriatric Assessment; D006801:Humans; D015601:Injury Severity Score; D007869:Leg Injuries / Q000175:diagnosis / Q000534:rehabilitation* / Q000601:surgery; D008297:Male; D009426:Netherlands; D026741:Physical Therapy Modalities / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D018570:Risk Assessment; D012307:Risk Factors; D012494:Sampling Studies; D012737:Sex Factors; D013997:Time Factors