Factors Predicting Mobility and the Change in Activities of Daily Living After Hip Fracture: A 1-Year Prospective Cohort Study

Journal of Orthopaedic Trauma
Massimo MaricondaMario Misasi

Abstract

To assess the change in ambulatory ability, need for walking aids, and activities of daily living (ADL) after femoral neck, intertrochanteric, or subtrochanteric fractures and to examine the determinants of these functional outcomes. A prospective observational cohort study. A multicenter study involving 1 university hospital and 2 community hospitals. A consecutive cohort of 552 patients (mean age, 78.3 years; range, 50-105) who underwent surgery for a hip fracture. Ambulatory ability, need for walking aids, and ADL index, 4 and 12 months after surgery. At both 4 months and 1-year follow-up time points, there was a significant decrease in ambulatory ability and the ADL index score and also an increase in the need for walking aids in comparison with the prefracture status. Ambulatory ability, but not ADL, significantly recovered between the 4-month and 1-year follow-up. One year after fracture, the prefracture functional status was regained by 57% of the patients, but approximately 13% of the formerly ambulating patients were unable to walk. The prefracture status was the most important determinant of ambulatory ability, need for walking aids, and ADL. Comorbidities, a poor cognitive status, and non-weight-bearing status after ...Continue Reading

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