Functional ability before and after rehabilitation in elderly patients with shortening and/or rotational deformity of the lower limb after hip fracture

PM R. 2023 Sep;15(9):1106-1114. doi: 10.1002/pmrj.12910. Epub 2022 Dec 13.

Abstract

Background: Shortening and rotational deformity of the lower limb (SRD) is a major complication of hip fracture surgery. It causes not only hip joint dysfunction but also functional impairments due to abnormal gait parameters, decreased gait velocity, and poor balance. Despite a number of previous studies, the effect of SRD on the postsurgical recovery of these patients is still not clear.

Objective: To compare the functional abilities and balance before and after rehabilitation for people with and without SRD after hip fracture surgery and to assess whether SRD affects rehabilitation.

Design: Prospective observational study.

Setting: Inpatients of a rehabilitation unit.

Participants: A total of 102 people with hip fracture (62 without SRD and 40 with SRD at the time of admission to the unit).

Main outcome measures: Berg Balance Scale (BBS) and Functional Independence Measure (FIM) motor score, administered before and after rehabilitation.

Interventions: Motor rehabilitation.

Results: Before rehabilitation, patients with SRD had lower motor-FIM (p = .002) and BBS (p = .001) scores than those without SRD. After rehabilitation, both groups showed similar improvements in motor-FIM, BBS, range of motion, muscle strength, and pain scores (p < .001, for all), but patients with SRD still had lower motor-FIM and BBS scores (p = .014 and .003, respectively) and lower effectiveness in motor-FIM and BBS (p = .039 and p = .034, respectively) than those without SRD.

Conclusions: SRD is associated with lower levels of balance and functional abilities before and after rehabilitation and it adversely affects rehabilitation for patients with hip fractures.

Publication types

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

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Hip Fractures* / surgery
  • Humans
  • Inpatients
  • Lower Extremity
  • Prospective Studies
  • Recovery of Function
  • Retrospective Studies
  • Treatment Outcome