RESUMO
This study sought to identify whether the inter-rater reliability of lower limb muscle strength measurements made using a hand-held dynamometer differs for patients with hip fracture according to the severity of their cognitive impairment. Of the 144 patients with hip fracture hospitalized at our institution, we excluded 28 from this study (18 with level III, IV, or M of independence in daily living for the demented elderly, 8 with a history of central nervous system disorders, and 2 who were transferred to another department), leaving 116 patients for analysis. These 116 patients were divided into three groups according to their severity of cognitive impairment: 44 with a normal level of independence in daily living for the demented elderly, 38 with level I independence, and 34 with level II independence. We compared the intra-class correlation coefficients and the standard error of measurement between the groups. There were no significant differences in the intra-class correlation coefficients between the groups. The standard error of measurement in the group with level II independence in daily living for the demented elderly was significantly lower than that in the other two groups. These findings indicate that the inter-rater reliability of lower limb muscle strength measurements using a hand-held dynamometer in patients with hip fracture did not differ between patients with mild or moderate cognitive impairment. Furthermore, the inter-rater reliability was high.
RESUMO
The purpose of this study was to clarify the effectiveness the score of the family’s ability to care to determine the discharge destination in patients with hip fractures. The subjects were 73 patients with hip fractures, who were admitted to the subacute care ward. They were classified into two groups: 48 patients who were discharged to home and 25, who were transferred to some other hospital or nursing home. The following parameters were compared between the two groups: sex, age, preinjury level of independence in daily living for the disabled elderly, level of independence in daily living for the demented elderly during hospitalization, FIM (Functional Independence Measure) at the time of discharge from hospital, number of family caregivers, familial care ability score, and length of hospitalization. The parameters presenting significant differences were used as independent variables in multiple logistic regression analysis, with discharge outcome as the dependent variable. The parameters presenting significant differences between the two groups were “FIM at hospital discharge” and “familial care ability score”. In addition, multiple logistic regression analysis revealed that “FIM at hospital discharge” and “familial care ability score” were significantly related to discharge outcome. Results of receiver operating characteristic analysis (area under the curve) for &ldqup;FIM at hospital discharge,” “familial care ability score,” and “FIM at hospital discharge＋familial care ability score” were 0.763, 0.681, and 0.786, respectively. Furthermore, the area under the curve for “FIM at discharge＋familial care ability score” was higher compared with those for the other parameters. Thus, we demonstrated that familial care ability score was effective in determining the discharge destination in patients with hip fractures.
