The journal of nutrition, health & aging

, Volume 23, Issue 10, pp 1034–1042 | Cite as

Functional Outcomes of Fragility Fracture Integrated Rehabilitation Management in Sarcopenic Patients after Hip Fracture Surgery and Predictors of Independent Ambulation

  • S.-K. Lim
  • J. Beom
  • S. Y. Lee
  • Jae-Young LimEmail author



To compare the changes in the functional level of patients with versus without sarcopenia who received by fragility fracture integrated rehabilitation management (FIRM) after hip fracture (HF) surgery over a 6-month follow-up period and to identify variables influencing independent ambulation (IA) at 6 months after HF.


Prospective observational study.


Three in-hospital rehabilitation setting.


Patients older than 65 years of age (N=80) categorized by the presence of sarcopenia.


The FIRM program during the-2 week hospital stay after surgery.


Main outcomes for ambulatory function (Koval score, Functional Ambulatory Category) and other secondary outcomes were measured at rehabilitation admission, at discharge, at 3 months and 6 months after surgery. Other secondary outcomes were measured. The possibility of IA at 6 months after surgery were also investigated.


Sarcopenia and non-sarcopenia patients did not differ significantly in terms of changes in ambulation or other functions over a 6-month follow-up (p < 0.001 or p = 0.001). The two groups did not differ significantly in terms of final functional status (6 months). The IA ratios of the two groups did not significantly differ at 6 months after surgery (sarcopenia [54.3%] and non-sarcopenia [64.5%]). IA before fracture (p = 0.039) and age (≥80 years) (p = 0.03) were independent predictors and sarcopenia was not a predictor for the possibility of IA at 6-months after surgery.


The FIRM program was effective for promoting functional recovery in older patients with fragility HF, either with or without sarcopenia. The present findings provide evidence of the pressing need for integrated rehabilitation management in fragility fracture care to improve functional recovery in patients with sarcopenia.

Key words

Clinical pathways geriatrics hip fractures rehabilitation sarcopenia 



This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Republic of Korea (Grant Number: HC15C1189).

Conflict of interest: The authors have no conflicts of interest to disclose.

Ethical standards: This study was approved by the Institutional Review Boards of Seoul National University Bundang Hospital (B-1603-337-002), Chung-Ang University Hospital (C2016117[1860]), and Jeju National University Hospital (JEJUNUH 2016-11-001), and written informed consent was obtained from all participants.


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Copyright information

© Serdi and Springer-Verlag International SAS, part of Springer Nature 2019

Authors and Affiliations

  • S.-K. Lim
    • 1
  • J. Beom
    • 2
  • S. Y. Lee
    • 3
  • Jae-Young Lim
    • 4
    • 5
    • 6
    Email author
  1. 1.Department of Physical Medicine and RehabilitationGyeongsang National University Changwon Hospital, Gyeongsang National University School of MedicineChangwonRepublic of Korea
  2. 2.Department of Physical Medicine and RehabilitationChung-Ang University Hospital, Chung-Ang University College of MedicineSeoulRepublic of Korea
  3. 3.Department of Rehabilitation MedicineSMG-SNU Boramae Medical CenterSeoulRepublic of Korea
  4. 4.Department of Rehabilitation MedicineSeoul National University Bundang Hospital, Seoul National University College of MedicineSeongnamRepublic of Korea
  5. 5.Institute on AgingSeoul National UniversitySeoulRepublic of Korea
  6. 6.Seoul National University College of Medicine, Seoul National University Bundang HospitalSeongnam, Gyeonggi-doRepublic of Korea

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