Assessment of functional capability and on-going falls-risk in older institutionalized people after total hip arthroplasty for femoral neck fractures.
OBJECTIVE
To estimate functional capability and attendant falls-risk in older institutionalized people after total hip arthroplasty (THA) for femoral neck fractures.


METHODS
The study population comprised 149 consecutive patients (F104, M45; mean age 83.4 years) who were permanent residents of nursing care facilities four weeks after THA for femoral neck fractures. Individual mental and functional capability status was assessed using the Mini Mental State Examination (MMSE), Timed Up and Go test (TUG) and Tinetti's Performance Oriented Mobility Assessment (POMA) which includes sub-scales for balance (B) and gait (G), in conjunction with identifying any concomitant disorders, reviewing individual pharmacotherapy and leisure time activities.


RESULTS
The subjects' mean MMSE was 23.1 points, whereas in Tinetti's POMA they scored 19 points on average, which translated into a five-fold greater falls-risk, whereas average TUG scores of 23.9s effectively corroborated this assertion. Multiple regression analysis effectively highlighted that TUG scores were strongly correlated with the actual number of concomitant disorders, number of regularly taken medications, and usual manner of spending leisure time.


CONCLUSIONS
Institutionalized older people after THA for femoral neck fracture continue to be exposed to high risk of recurrent, possibly injurious falls, which is closely correlated with significantly diminished individual functional capabilities.
Department of Physical Rehabilitation in Rheumatology and Geriatrics, University School of Physical Education, Al. Jana Pawła II # 78, PL-31-571 Krakow, Poland; Department of Physiotherapy, The Andrzej Frycz Modrzewski Krakow University, ul. G. Herlinga-Grudzińskiego 1, PL-30-705 Krakow, Poland. Electronic address: mzak1@onet.eu.
Marek
M
Zak
University School of Physical Education, Al. Jana Pawła II # 78, PL-31-571 Krakow, Poland. Electronic address: krupny@gmail.com.
Szymon
S
Krupnik
University School of Physical Education, Al. Jana Pawła II # 78, PL-31-571 Krakow, Poland. Electronic address: grzegorz.puzio@gmail.com.
Grzegorz
G
Puzio
University School of Physical Education, Al. Jana Pawła II # 78, PL-31-571 Krakow, Poland. Electronic address: izabelasgf@o2.pl.
Izabela
I
Staszczak-Gawelda
University School of Physical Education, Al. Jana Pawła II # 78, PL-31-571 Krakow, Poland. Electronic address: a.czesak@gmail.com.
Joanna
J
Czesak
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D003430:Cross-Sectional Studies; D005260:Female; D005265:Femoral Neck Fractures / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D020127:Recovery of Function; D018570:Risk Assessment; D013997:Time Factors
Elderly; Falls-risk; Functional capability; TUG; Total hip arthroplasty