European Geriatric Medicine

, Volume 9, Issue 5, pp 641–650 | Cite as

Comparative outcomes of inpatient fragility fracture intensive rehabilitation management (FIRM) after hip fracture in sarcopenic and non-sarcopenic patients: a prospective observational study

  • Seung-Kyu Lim
  • Sang Yoon Lee
  • Jaewon Beom
  • Jae-Young Lim
Research Paper



To evaluate the effects of fragility fracture integrated rehabilitation management (FIRM) on the functional outcomes of sarcopenic and non-sarcopenic inpatients following hip fracture surgery.


This prospective observational study was carried out with patients over 65 years of age who underwent hip surgery for fragility hip fracture and received multidisciplinary rehabilitation. Sarcopenia was defined according to the Asian Working Group for Sarcopenia criteria. Demographic and functional characteristics were analyzed before and after rehabilitation during inpatient care to evaluate short-term outcomes.


Sixty-eight patients were eligible for the study, and 32 (47.1%) satisfied the criteria for sarcopenia. The pre-fracture ambulatory status was lower in the sarcopenia group (KOVAL: 1.74 ± 1.42 vs. 1.22 ± 0.42, p = 0.022). The overall functional levels were significantly lower in the sarcopenia group before and after rehabilitation. Overall function was significantly improved in both groups after FIRM, and with the exception of Korean Instrumental Activities of Daily Living scores, there were no differences between the groups in the changes after FIRM. Pre-fracture independent ambulatory function was significantly correlated with short-term ambulatory functional recovery in both sarcopenia and non-sarcopenia groups [n = 22 (91.7%), p = 0.023 vs. n = 27 (84.4%), p = 0.028].


Our results suggest that FIRM was effective for short-term functional recovery in older patients with or without sarcopenia who have suffered fragility hip fracture. Considering sarcopenia, which has a detrimental effect on functional outcomes after rehabilitation, the impact of sarcopenia on FIRM should be investigated further over a longer period of time.


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).

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Institutional Review Board of Seoul National University Bundang Hospital (B-1603-337-002) and Chung-Ang University Hospital [C2016117(1860)].

Informed consent

Written informed consent was obtained from all enrolled participants for FIRM.


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Copyright information

© European Geriatric Medicine Society 2018

Authors and Affiliations

  1. 1.Department of Physical Medicine and RehabilitationGyeongsang National University Changwon Hospital, Gyeongsang National University School of MedicineChangwonRepublic of Korea
  2. 2.Department of Rehabilitation MedicineSeoul Metropolitan Government Seoul National University Boramae Medical CenterSeoulRepublic of Korea
  3. 3.Department of Physical Medicine and RehabilitationChung-Ang University College of MedicineSeoulRepublic of Korea
  4. 4.Department of Rehabilitation MedicineSeoul National University Bundang Hospital, Seoul National University College of MedicineSeongnamRepublic of Korea

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