Effects of Increase in Rehabilitation Sessions on Functional Outcome of Hip Fractures in Subacute Phase / 日本農村医学会雑誌

ABSTRACT

　　This study is designed to clarify the effects of increases in a rehabilitation session on the functional outcome of hip fractures in the subacute phase.　　Of 95 patients with hip fractures admitted to our subacute care ward between November 2010 and March 2012, five patients transferred to another ward due to complications were excluded, and 90 patients were taken up. The 90 patients were divided into two groups 22 patients who underwent rehabilitation before an increase in the frequency of rehabilitation sessions (early-phase group) and 68 who underwent rehabilitation after an increase in the frequency (later-phase group). Outcomes, such as the number of rehabilitation sessions, length of hospital stay, FIM at the time of discharge, FIM efficiency and destination after hospital discharge, were compared between the two groups.　　In a comparison of all patients, the number of rehabilitation sessions significantly increased (p<0.001), but there was no significant difference in FIM at the time of discharge from hospital, FIM efficiency and post-discharge destination. Group “Rank A” stood out in a comparison of the degree of independence enjoyed by the disabled elderly in their daily life before they suffered injuries (p<0.05). Group “Rank I” stood out in a comparison of the degree of independence in the daily life by the elderly with dementia, while they were in hospital (p⁢0.05). The FIM efficiency of the later-phase group was significantly higher than that of the early-phase group.　　It is presumably effective to begin intensive rehabilitation for patients whose ADL ability is somewhat reduced and those who have cognitive impairments. It has been thought that cognitive impairment was one of the factors that inhibit rehabilitation for hip fractures. However, it has been suggested that improvements in ADL are possible with increases in rehabilitation sessions for cases with mild cognitive impairment.