title: Can hip-fractured elderly patients maintain their rehabilitation achievements after 1 year?
abstract: OBJECTIVE
  The purpose of this study is to characterize hip-fractured patients who maintained or improved their functional ability, 1 year postdischarge from rehabilitation and to identify factors associated with functional achievement maintenance.
  
  
  METHODS
  A retrospective study performed in a postacute geriatric rehabilitation center. Two hundred thirty-three hip-fractured patients admitted consecutively from January 2006 to September 2007 were enrolled in the study. The patients were evaluated at discharge from rehabilitation and after 1 year, they were classified into two groups: those who maintained or improved their motor Functional Independence Measure (mFIM) scores and those who deteriorated. The differences between the two patient groups relating to functional, clinical, demographic and fracture-related variables were assessed.
  
  
  RESULTS
  One year postrehabilitation, 130 (55.8%) patients exhibited a decline in their mFIM score. Patients whose 1-year mFIM score had improved were discharged from rehabilitation with a less favorable mean mFIM score (50.7 ± 18.5 vs. 55.6 ± 15.2; p = 0.032), achieved a lower mean mFIM score gain during rehabilitation (12.0 ± 9.7 vs. 14.6 ± 8.1; p = 0.03), had a higher education level (p = 0.003) and had a lower rate of chronic lung disease (p = 0.020) compared with patients whose 1-year mFIM score had deteriorated. After 1 year, only 21 patients (9%) were functionally independent in activities of daily living and only 19 (8.2%) were able to walk unassisted. Only 13 patients (5.6%) perceived that they had regained their former functional level.
  
  
  CONCLUSIONS
  A substantial decline in functional ability of hip-fractured patients occurred 1 year postdischarge from rehabilitation. Healthcare providers should be aware of the necessity for a long-term postrehabilitation physical training program to prevent functional decline. Further efforts should be invested in motivating their patients to exercise.
authors.affiliation: Beit Rivka Geriatric Rehabilitation Center, Petach Tikva, Israel. avitalhe@clalit.org.il
authors.forename: Avital
authors.initials: A
authors.lastname: Hershkovitz
authors.forename: Irina
authors.initials: I
authors.lastname: Pulatov
authors.forename: Shai
authors.initials: S
authors.lastname: Brill
authors.forename: Yichayaou
authors.initials: Y
authors.lastname: Beloosesky
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000401:mortality / Q000534:rehabilitation*; D006801:Humans; D007902:Length of Stay; D010351:Patient Discharge; D011379:Prognosis; D020127:Recovery of Function; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D012944:Social Support; D012959:Socioeconomic Factors; D013997:Time Factors; D016896:Treatment Outcome