Effectiveness of a multidisciplinary rehabilitation program in elderly patients with hip fractures

Background and purpose: Hip fracture is a significant health challenge to t he elderly, with a high risk of complications, long hospital stay, and func tional deterioration. The purpose of this study was to evaluate the effecti veness of a multidisciplinary rehabilitation program (MRP) in older patient s with hip fractures. Methods: A before-and-after quasi-experimental design was used. Data were c ollected at a large teaching hospital in Taipei. The first 105 consecutive patients admitted received conventional care (control group). The next 50 c onsecutive patients received physical therapy, nurse-supervised exercise, a nd discharge planning (intervention group). Subjects were assessed upon adm ission, on the fourth postoperative day, and on the discharge day. The 155 patients recruited met the following criteria: 60 years of age or older, an d hospitalized to receive either closed reduction and internal fixation, or hip arthroplasty. Results Compared with the control group, the intervention group had a short er average hospital stay (9.9 vs 11.6 days, p = 0.01), earlier ambulation ( 5.7 vs 6.5 days postoperatively), and a lower rate of bowel incontinence (4 .0% vs 23.8%) and pressure sores (14.0% vs 24.8%) during hospitalization. T he intervention group experienced less decline in mobility (relative to pre -fracture status) than the control group. No significant difference was fou nd in other outcome variables between the control and intervention groups. Conclusions: The findings of this study indicate that an MRP involving phys ical therapy, nurse-supervised exercise, and discharge planning positively affects health outcomes in older patients with hip fractures.