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Changes in Basic Movement Ability and Activities of Daily Living After Hip Fractures: Correlation Between Basic
Shogo Toyama1, Koshiro Sawada, Keiichiro Ueshima
1From the Departments of Orthopaedics (ST, KU, TK), and Rehabilitation Medicine (KS, YM), Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto; Bodaijyu Nursing Home, Oita (IM); Medical Corporation of Kenseikai, Oita (KT); and Department of Social Services and Healthcare Management, School of Health and Welfare, International University of Health and Welfare, Chiba (TT), Japan.
Objective:
The aim of this study was to examine the correlation between basic movement ability and activities of daily living (ADL) in elderly patients after hip fracture surgery and predict ADL outcomes from changes in basic movement ability.
Design:
Fifty-four patients receiving rehabilitation after hip fracture surgery were collected prospectively. Ambulatory ability was evaluated using a Basic Movement Scale (BMS), and ADL was evaluated using the motor subscale of the Functional Independence Measure (motor-FIM). From the results of evaluating BMS and motor-FIM weekly, the important postoperative period to regain ADL was investigated.
Results:
There was a close correlation between BMS and motor-FIM scores at each evaluation point (r = 0.971, P < 0.001) and a significant correlation between weekly BMS and motor-FIM gains (r = 0.741, P < 0.001). Cluster analysis of BMS scores from postoperative week (POW) 2 to 12 showed three patterns of change, with BMS scores at POW 2 reflecting the outcome.
Conclusions:
The very strong correlation between BMS and motor-FIM scores suggests that BMS is a favorable indicator of changes in ADL. Because basic movement ability at POW 2 also reflected the prognosis, constructive interventions should be implemented early to help patients ambulate and regain other basic movements by no later than POW 2.
