Bibliographic reference
Journal of Multidisciplinary Healthcare, Chun-Feng Huang, Po-Jung Pan, Yi-Hung Chiang, Shung-Haur Yang; A Rehabilitation-Based Multidisciplinary Care Model Reduces Hip Fracture Mortality in Older Adults.
At a glance
In the elderly, osteoporosis can cause fractures and have serious consequences. Hip fractures, in particular, are related to a high rate of complications and mortality. An appropriate post-surgical approach can prevent some of the complications, bring several benefits to motor skills and the psychological state, and reduce falls and mortality. To this end, a multidisciplinary rehabilitation approach is the most recommended.
The context
Hip fractures related to osteoporosis are some of the most serious complications of aging and can be considered one of the main causes of death among the elderly. This study conducted in Taiwan aims at identifying the best treatment (in terms of general physical function, risk of fall, re-fracture and mortality rate) for patients with surgically treated hip fractures. Two treatments were compared for this purpose. The first is a standard treatment which consists of performing physical activity without the supervision of a physical therapist. The second treatment, called i-HOPE (Integrated Hip Fracture and Osteoporosis Rehabilitation Program for the Elderly), offers multidisciplinary care focused on rehabilitation, osteoporosis therapy and home adaptation.
The characteristics of the study
The retrospective study included 185 people over the age of 65, with a history of non-traumatic hip fracture, and who underwent surgery between February 2014 and March 2017. The patients were separated into 2 groups: those who received the standard treatment (surgery + physical activity without supervision) and those who participated in the i-HOPE program. The i-HOPE protocol provides physical therapy for limb strengthening and walking recovery, occupational therapy aimed at improving the home environment, and the appropriate treatment for osteoporosis. Assessment scales related to emotional status, physical activity, gait and balance were compared.
The results
i-HOPE patients achieved significantly better scores in all evaluated areas (mood, physical activity, walking, balance) than patients who received the standard treatment. In addition, the i-HOPE patients demonstrated lower rates of falls, re-fractures, and mortality after one year. Quale la novità This study shows that for patients who have had surgery after fragility hip fractures, the multidisciplinary approach – consisting of rehabilitation, osteoporosis therapy and improvements of the home environment – achieves functional improvement, reduces the risk of fracture, and reduces the risk of mortality.
The news and the prospects
Given this significant result, physical activity alone, without the supervision of a physical therapist, is not to be considered an effective approach for patients who have suffered from hip fractures. Instead, multidisciplinary care is the most recommended approach for these patients.
Edited by Alessio Baricich and Daria Cuneo.
