title: Hip fracture-related pain strongly influences functional performance of patients with an intertrochanteric fracture upon discharge from the hospital.
abstract: OBJECTIVE
  To examine whether functional performance upon hospital discharge is influenced by pain in the region of the hip fracture or related to the fracture type.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  A 20-bed orthopedic hip fracture unit.
  
  
  METHODS
  Fifty-five cognitively intact patients (20 men and 35 women; ages 75.8 ± 10 years), 33 with a cervical hip fracture and 22 with an intertrochanteric hip fracture, all of whom were allowed to bear full weight after surgery.
  
  
  METHODS
  All patients were evaluated upon discharge from the hospital to their own homes at a mean of 10 ± 6 days after surgery.
  
  
  METHODS
  The Timed Up & Go (TUG) test, supervised by a physical therapist, was used to evaluate functional performance, and a 5-point verbal ranking scale (0 = no pain to 4 = intolerable pain) was used to evaluate pain.
  
  
  RESULTS
  Patients took an average of 22.7 ± 11.7 seconds to perform the TUG. No significant differences were observed in baseline characteristics or pain medication given for patients with a cervical versus an intertrochanteric fracture (P ≥ .22), but patients with an intertrochanteric fracture presented more often with moderate to severe pain during testing (P < .001), with associated poorer performances on the TUG test (29.4 ± 12.8 seconds versus 18.3 ± 8.5 seconds). Univariate analysis showed that TUG scores were associated with age, prefracture function evaluated by the New Mobility Score, fracture type, day of TUG performance, and pain intensity. Multivariate linear regression analyses (fracture type not included) showed that only greater age (B = 0.34), low prefracture function (B = 7.9), and experiencing moderate to severe pain (B = 8.7) were independently associated with having a poorer TUG score.
  
  
  CONCLUSIONS
  Hip fracture-related pain primarily compromises the functional performance of patients with an intertrochanteric hip fracture upon discharge from hospital. Physical therapists should be involved in new and optimized fracture-type stratified pain management strategies.
authors.affiliation: Department of Physical Therapy, 236, and Orthopedic Surgery, Hvidovre University Hospital, Kettegaard Alle 30, Copenhagen DK-2650, Denmark. mortentange@hotmail.com
authors.forename: Morten Tange
authors.initials: MT
authors.lastname: Kristensen
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000150:complications* / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D010146:Pain / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D010351:Patient Discharge; D011446:Prospective Studies; D014193:Trauma Centers; D016138:Walking / Q000502:physiology*