Evaluation of the functional training program for the elderly after hip surgery

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Evaluation of the functional training program for the elderly after hip surgery

 

Author: Soo, Ka-wai Antonia
Title: Evaluation of the functional training program for the elderly after hip surgery
Degree: M.Sc.
Year: 2004
Subject: Hong Kong Polytechnic University -- Dissertations
Hip joint -- Surgery -- Patients -- Rehabilitation
Older people -- Surgery -- Rehabilitation
Department: Dept. of Rehabilitation Sciences
Pages: xi, 104 leaves : ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1772727
URI: http://theses.lib.polyu.edu.hk/handle/200/5102
Abstract: Hip fracture is a leading cause of disability and mortality among the elderly. Previous studies found that effectiveness of geriatric orthopaedic rehabilitation was inconclusive. The aim of this study was to investigate the effect of a Functional Training Program (FTP) for elderly after hip surgery. A prospective, randomized controlled trial (RCT) was conducted on a group of elderly patients with hip fractures and to investigate the effect of this FTP. The FTP aimed at both functional independence and fall related self-efficacy enhancement, which is consisted of a three-week training program including a comprehensive training on activities of daily living (ADL), ADL task modifications and behaviour adjustment. Functional Independence Measure (FIM) and Fall Efficacy Scale (FES) were used as outcome measurement. 60 subjects aged 65 or above, with hip surgery and intact cognitive function were recruited in the study. They were randomly assigned into treatment group (FTP) and control group (conventional occupational therapy (OT) training). Mean age was 78.77 years old. Subjects in both treatment groups share similar baseline demographics, mental function, admission FIM and FES scores (p >.05). Results showed that the FTP group had significant higher total FIM score (112.71+-3.87 vs. 105+-9.55) and total FES score (81.10+-10.08 vs. 46.27+-19.97) (p <.01) than that in the conventional OT training group. There was a high correlation between the total FIM score and total FES score (r=.80 , p <.01). The average length of stay (LOS) was 24.7 days and the FTP group had significant shorter LOS (mean = 21.53 days) than that in the conventional OT training group mean = 27.87 days). The average total FIM change efficiency was 0.80 and additional 0.40 total FIM change efficiency was noted in the FTP group when compared with the conventional OT training group (p < .01). 90% of subjects were discharged home and only four subjects in this study had changed their residence from home to old aged home. Upon three-month follow-up, 90% of all subjects resumed premorbid ADL function. 18.3% of subjects resumed premorbid ambulatory level and 95% of them were able to walk independently with or without aids. The FTP was found to be effective in improving functional status and fall related self-efficacy for elderly after hip surgery. They had shorter LOS, higher functional independence and higher fall related self-efficacy. The improvement was maintained after three months of the program. Comprehensive ADL training and fall related self-efficacy should be considered as a target for intervention of geriatric hip fractures.

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