Upper-limb motor and sensory function in patients with hip fracture: Comparison with community-dwelling older adults.

BACKGROUND: Upper-limb function is important in patients with hip fracture so they can perform activities of daily living and participate in leisure activities. Upper-limb function of these patients, however, has not been thoroughly investigated. OBJECTIVE: The aim of this study was to evaluate the upper-limb motor and sensory functions in patients with hip fracture by comparing these functions with those of community-dwelling older adults (control group). METHODS: We compared the results of motor and sensory function tests of upper-limb function - range of motion, strength, sensibility, finger dexterity, comprehensive hand function - between patients with hip fracture (n= 32) and the control group (n= 32). RESULTS: Patients with hip fracture had significantly reduced grip strength, pinch strength, finger dexterity, and comprehensive hand function compared with the control group. CONCLUSIONS: Most upper-limb functions are impaired in the patients with hip fracture. Thus, upper-limb function of patients with hip fracture should be considered during treatment.

Exploring the factor on sensory motor function of upper limb associated with executive function in communitydwelling older adults.

Exercise, such as cardiovascular fitness training, has been shown to have utility in improving executive function but is difficult for older adults with low mobility to perform. Accordingly, there is interest in the development of regimens other than high mobility exercises for older adults with low mobility. The aim of the present study was to evaluate the association between sensory motor function of the upper limb and executive function in community-dwelling older adults. A cross-sectional study was conducted in 57 right-handed, independent, community-dwelling older adults. Sensory motor function of upper limb, including range of motion, strength, sensation, finger dexterity, and comprehensive hand function was measured in both hands. Executive function was assessed using the Delta Trail Making Test. Multiple regression analysis indicated the finger dexterity of the non-dominant hand as independently associated with executive function (ß = -0.414, P < 0.001). The findings of the present study may facilitate the development of exercise regimens for improving executive function that are more suitable for older adults with limited physical fitness levels. As this was a cross-sectional study, further studies are required to validate the efficacy of non-dominant finger dexterity training for improving executive function in older adults.

Factors affecting the discharge destination of hip fracture patients who live alone and have been admitted to an inpatient rehabilitation unit.

[Purpose] (1) The aim of this study was to examine relations between clinical and functional assessment and discharge destination and (2) to identify the optimal cutoff point for estimating discharge to home after inpatient rehabilitation. [Subjects] The subjects were 54 hip fracture patients (15 males, 39 females; mean age 81.3 ± 7.4 years) living alone. [Methods] The patients were classified into two groups: those discharged to home and those admitted to an institution. Age, gender, side of fracture, fracture type, number of comorbidities, Functional Independence Measure motor score, and Functional Independence Measure cognitive score were compared between groups. Multiple logistic regression analysis was conducted with discharge to home as the dependent variable and age, gender, side of fracture, fracture type, number of comorbidities, Functional Independence Measure motor score, and Functional Independence Measure cognitive score as independent variables. A receiver operating characteristic curve analysis was used to identify a cutoff point for classification of the patients into the two groups. [Results] Multiple logistic regression analysis showed that the Functional Independence Measure cognitive score was a significant variable affecting the discharge destination. The receiver operating characteristic curve analysis revealed that discharge to home was predicted accurately by a Functional Independence Measure cognitive score of 23.5. [Conclusion] Information from this study is expected to be useful for determining discharge plans and for the setting of treatment goals.