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Physical therapy and mobility 2 and 6 months after hip fracture
Joan D Penrod1, Kenneth S Boockvar, Ann Litke
1Program 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
Objectives:
To examine the relationship between early physical therapy (PT), later therapy, and mobility 2 and 6 months after hip fracture.
Design:
Prospective, multisite observational study.
Setting:
Four hospitals in the New York City area.
Participants:
Four hundred forty-three hospitalized older patients discharged after surgery for hip fracture in 1997-98.
Measurements:
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.
Conclusion:
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.
