Physical therapy and mobility 2 and 6 months after hip fracture.
OBJECTIVE
To examine the relationship between early physical therapy (PT), later therapy, and mobility 2 and 6 months after hip fracture.


METHODS
Prospective, multisite observational study.


METHODS
Four hospitals in the New York City area.


METHODS
Four hundred forty-three hospitalized older patients discharged after surgery for hip fracture in 1997-98.


METHODS
Patient demographics, fracture type, comorbidities, dementia, number of new impairments at discharge, amount of PT between day of surgery and postoperative day (POD) 3, amount of therapy between POD4 and 8 weeks later, and prefracture, 2-, and 6-month mobility measured using the Functional Independence Measure.


RESULTS
More PT immediately after hip fracture surgery was associated with significantly better locomotion 2 months later. Each additional session from the day of surgery through POD3 was associated with an increase of 0.4 points (P=.032) on the 14-point locomotion scale, but the positive relationship between early PT and mobility was attenuated by 6 months postfracture. There was no association between later therapy and 2- or 6-month mobility.


CONCLUSIONS
PT immediately after hip fracture surgery is beneficial. The effects of later therapy on mobility were difficult to assess because of limitations of the data. Well-designed randomized, controlled trials of the effect of varying schedules and amounts of therapy on functional status after hip fracture would be informative.
Penrod
Joan D
JD
Program of Research on Serious Physical and Mental Illness and Geriatric Research, Education, and Clinical Center, Bronx Veterans Affairs Medical Center, New York, New York, USA. joan.penrod@mssm.edu
Boockvar
Kenneth S
KS
Litke
Ann
A
Magaziner
Jay
J
Hannan
Edward L
EL
Halm
Ethan A
EA
Silberzweig
Stacey B
SB
Sean Morrison
R
R
Orosz
Gretchen M
GM
Koval
Kenneth J
KJ
Siu
Albert L
AL
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006620:Hip Fractures / Q000503:physiopathology* / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D020127:Recovery of Function; D013997:Time Factors