Municipality-based physical rehabilitation after acute hip fracture surgery in Denmark

Dan Med J. 2015 Apr;62(4):A5023.

Abstract

Introduction: Patients who are surgically treated for an acute hip fracture in Denmark commence early in-hospital physical rehabilitation (PR) with more than 95% of patients referred to further PR following discharge. However, the specifics of the PR services after discharge are unknown. Thus, the aim of the present paper was to describe the specifics of PR provided to patients following discharge after hip fracture (HF) surgery in Denmark to evaluate the need for future interventions or guidelines.

Methods: This was a national, cross-sectional questionnaire survey including 56 randomly selected municipalities out of 98. Information was gathered on PR and categorised into outpatient PR (including one-to-one and group), home-based PR, 24-hour in-patient PR units and nursing homes.

Results: Sixty PR centres (97%) within 51 municipalities (91%) participated. The PR was initiated within 1-2 weeks after the municipality had received a referral from the hospital in 97% of the participating centres. The duration of PR was 8-12 weeks or 4-7 weeks in 85% of the centres, and most often comprised 1-2 training sessions per week. In all, 72% out of 56 municipalities returned a specific PR programme of which only 14% provided specific information regarding the intensity and the progression of training.

Conclusion: PR after hip fracture in Denmark is initiated shortly after referral, for a variable duration of time and with poorly described exercise intensity and progression. This calls for a national description and implementation of an optimised PR programme according to the best available evidence.

Funding: The study was supported by grants from The IMK Foundation, The Research Foundation of the Capital Region, The Research Foundation of the Danish Physical Therapy Organization, The Research Foundation of Hvidovre Hospital and The UCSF Lundbeck Foundation. The funding agencies had no influence on the study design, methods, subjects, data collection, analyses or on the manuscript.

Trial registration: not relevant.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Community Health Services / organization & administration*
  • Continuity of Patient Care
  • Cross-Sectional Studies
  • Denmark
  • Exercise Therapy / methods*
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / methods
  • Fracture Fixation, Internal / rehabilitation*
  • Hip Fractures / diagnostic imaging
  • Hip Fractures / rehabilitation*
  • Hip Fractures / surgery
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Pain Measurement
  • Patient Discharge / statistics & numerical data
  • Radiography
  • Range of Motion, Articular / physiology*
  • Recovery of Function
  • Rehabilitation Centers / organization & administration
  • Risk Assessment
  • Surveys and Questionnaires*
  • Treatment Outcome