Effectiveness of preoperative physical therapy for older patients with hip fracture

To clarify the effectiveness of preoperative physical therapy for older patients after hip fracture in an acute care hospital.

In the present retrospective observational study, data from the Japan Rehabilitation Database were analyzed for patients admitted to an acute care hospital with hip fracture between 2005 and 2015. In this study, all eligible patients received surgery within 10 days of admission. Propensity score analysis was used to compare outcomes between patients who underwent preoperative rehabilitation and those who did not. The primary outcome was motor Functional Independence Measure (FIM) gain.

Of the 681 patients eligible after applying exclusion criteria, 50% underwent preoperative rehabilitation after hip fracture. Both before and after adjustment by inverse probability weighting, motor FIM gain was significantly higher in patients who underwent preoperative rehabilitation (motor FIM gain 31.1 ± 18.2 before weighting, 31.1 ± 18.2 after weighting) than in those who did not (motor FIM gain 24.6 ± 18.1 before weighting, P < 0.01; 26.2 ± 17.6 after weighting, P < 0.02). In addition, motor FIM effectiveness and motor FIM at discharge were significantly higher among patients who underwent preoperative rehabilitation.

Our data suggest that preoperative rehabilitation after hip fracture is associated with better rehabilitation outcomes than no preoperative rehabilitation. Geriatr Gerontol Int 2018; 18: 1003-1008.