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Archives of Orthopaedic and Trauma Surgery

, Volume 138, Issue 1, pp 35–41 | Cite as

Which factors are independent predictors of early recovery of mobility in the older adults’ population after hip fracture? A cohort prognostic study

  • Mattia MorriEmail author
  • Cristiana Forni
  • Maura Marchioni
  • Elena Bonetti
  • Francesca Marseglia
  • Andrea Cotti
Trauma Surgery

Abstract

Introduction

The aim of the present study was to identify all factors that might influence the short-term recovery of mobility in older adults’ patients after hip surgery.

Methods

A prospective cohort prognostic study was carried out. The study enrolled all consecutive patients aged 65 years or over admitted for hip fracture due to fragility. Patients were monitored from their admission into the emergency department of the hospital, until their discharge. The level of mobility was measured by the ILOA scale, administered during the 6th day of hospitalisation. The identified variables were divided into baseline patient variables, linked to the patient’s characteristics, and, healthcare/hospital variables, linked to the program of care within post-surgery hospitalisation.

Results

The total number of patients enrolled and examined at discharge was 484. Six days after surgery, the level of mobility achieved by patients, as measured by ILOA Scale, was 42.4 (± 6.0). Increased age (B = 0.111; p = 0,042), pressure sore mattress with a motor used (B = 3.817; p < 0.0005), delay in achieving an upright position (B = 0.509; p < 0.0005), no recovery of walking (b = 2.339; p < 0.0005), prolonged use of diapers (B = 0.004; p < 0.0005) or catheter (B = 0.089; p < 0.0005), indication for no weight bearing (B = 2.023; p = 0.031), and temperature for fewer days (B = 0.040; p = 0.023) are factors able to affect negatively recovery of mobility in the initial post-operative period in patients surgically treated for hip fracture.

Conclusion

Therapy and physiotherapy choices after surgery for hip fracture are significantly associated with early recovery of mobility of older adults’ patients, regardless of their baseline conditions. Early removal of supporting devices promoting prolonged bed immobility, such as air mattress, catheter, and incontinence pad, together with achieving an early upright position, are elements to take into account when planning future trials to understand its efficacy in enabling better recovery of mobility.

Keywords

Hip fracture Early ambulation Rehabilitation Nursing care Postoperative care 

Notes

Compliance with ethical standards

Ethics committee approval

All procedures performed in studies involving human participants were in accordance with the ethics standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethics standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare that they have no potential conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Istituto Ortopedico Rizzoli, Servizio Assistenziale Infermieristico Tecnico e Riabilitativo BolognaBolognaItaly

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