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Effects of fragility fracture integrated rehabilitation management on mobility, activity of daily living and cognitive functioning in elderly with hip fracture |
Aftab A, Awan WA, Habibullah S, Lim JY |
Pakistan Journal of Medical Sciences 2020 Jul-Aug;36(5):965-970 |
clinical trial |
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: No; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
OBJECTIVE: To determine the effectiveness of Fragility Fracture Integrated Rehabilitation Management (FIRM) on mobility, activity of daily living and cognitive functioning in elderly with hip fracture. METHODS: A randomized control trial was conducted at Seoul National University Bundang Hospital, South Korea from August 2017 to January 2018. Patients of both genders with the age 65 to 95 years, diagnosed cases of hip fracture specifically fractures neck of femur, intertrochanteric, subtrochantric, patients who got bipolar hemiarthroplasty, total hip replacement arthroplasty, reduction and internal fixation were included in this study. A total of n = 39 sample was collected through non probability convenience sampling technique and randomly divided into fragility integrated rehabilitation management (FIRM) group (n = 20) and conventional physical therapy (CPT) group (n = 19). The data was collected through KOVAL for walking ability, modified Barthal Index (MBI) for behaviors related to activities of daily living (ADLS) and mini mental status examination (MMSE) for cognitive functions at baseline on 2nd postoperative day and after 10th FIRM session on 15th postoperative day. RESULTS: The mean age of study participants was 82.07 +/- 6.00 years. The post intervention comparison did not show any significant difference (p > 0.05) in walking ability, overall ADLs and cognitive functioning. But FIRM group showed significant improvement in stair climbing (0 (5) versus 2 (7.5), p = 0.049) and ambulation or walker use (8 (5) versus 2 (4), p = 0.037), as compared to CPT group. CONCLUSION: Both groups improved in indoor mobility with walker and crutches as well as activities of daily living. But FIRM showed more improving ambulation with walker and stair climbing. While cognitive functioning was observed only in FIRM group.
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