Mobility improvement in the first 6 postoperative weeks in orthogeriatric fracture patients
© 2021. The Author(s)..
BACKGROUND: Physical activity is a relevant outcome parameter in orthopedic surgery, that can be objectively assessed. Until now, there is little information regarding objective gait parameters in the orthogeriatric population. This study focuses on the first 6 weeks of postoperative rehabilitation, and delivers objective data about gait speed and step length in typical orthogeriatric fracture patterns.
METHODS: Thirty-one orthogeriatric fracture patients [pertrochanteric femur fractures (PFF), femoral neck (FN), and proximal humerus fractures (PHF)] were consecutively enrolled in a maximum care hospital in a prospective study design. All patients wore an accelerometer placed at the waist during the postoperative stay (24 h/d) and at 6-week follow-up, to measure real gait speed and step length. In addition, self-assessment of mobility (Parker mobility score) and activities of daily living (Barthel index) were collected at baseline, during the inpatient stay, and at 6-week follow-up.
RESULTS: During postoperative hospitalization, significantly higher gait speed (m/s) was observed in the PHF group (0.52 ± 0.27) compared with the FN group (0.36 ± 0.28) and PFF group (0.19 ± 0.28) (p < 0.05). Six weeks postoperatively, gait speed improved significantly in all groups (PHF 0.90 ± 0.41; FN 0.72 ± 0.13; PFF 0.60 ± 0.23). Similarly, step length (m) differed between groups postoperatively [FN 0.16 ± 0.13; PFF 0.12 ± 0.15; PHF 0.31 ± 0.05 (p < 0.005)] and improved over time significantly (FN 0.47 ± 0.01; 0.39 ± 0.19; 0.50 ± 0.18). Self-assessment scores indicate that the majority of the patients had minor restrictions in mobility before the fracture. These values decreased immediately postoperatively and improved in the first 6 weeks, but did not reach the initial level.
CONCLUSIONS: Gait speed, step length, and self-assessment in terms of mobility and activities of daily living improve significantly in the first 6 postoperative weeks in orthogeriatric fracture patients. As very low postoperative mobility during hospitalization was observed, this collective shows great potential in postoperative rehabilitation regardless of their fracture pattern. For this reason, specific aftercare concepts similar to the "fast track" concepts in primary arthroplasty are crucial for orthogeriatric patients in clinical practice.
LEVEL OF EVIDENCE: Prospective cohort study, 2.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:48 |
|---|---|
| Enthalten in: |
European journal of trauma and emergency surgery : official publication of the European Trauma Society - 48(2022), 4 vom: 15. Aug., Seite 2867-2872 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Keppler, Alexander M [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Gait speed |
|---|
| Anmerkungen: |
Date Completed 10.08.2022 Date Revised 11.08.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00068-021-01856-0 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM334681308 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM334681308 | ||
| 003 | DE-627 | ||
| 005 | 20231226204014.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00068-021-01856-0 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1115.xml |
| 035 | |a (DE-627)NLM334681308 | ||
| 035 | |a (NLM)34932124 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Keppler, Alexander M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Mobility improvement in the first 6 postoperative weeks in orthogeriatric fracture patients |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 10.08.2022 | ||
| 500 | |a Date Revised 11.08.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021. The Author(s). | ||
| 520 | |a BACKGROUND: Physical activity is a relevant outcome parameter in orthopedic surgery, that can be objectively assessed. Until now, there is little information regarding objective gait parameters in the orthogeriatric population. This study focuses on the first 6 weeks of postoperative rehabilitation, and delivers objective data about gait speed and step length in typical orthogeriatric fracture patterns | ||
| 520 | |a METHODS: Thirty-one orthogeriatric fracture patients [pertrochanteric femur fractures (PFF), femoral neck (FN), and proximal humerus fractures (PHF)] were consecutively enrolled in a maximum care hospital in a prospective study design. All patients wore an accelerometer placed at the waist during the postoperative stay (24 h/d) and at 6-week follow-up, to measure real gait speed and step length. In addition, self-assessment of mobility (Parker mobility score) and activities of daily living (Barthel index) were collected at baseline, during the inpatient stay, and at 6-week follow-up | ||
| 520 | |a RESULTS: During postoperative hospitalization, significantly higher gait speed (m/s) was observed in the PHF group (0.52 ± 0.27) compared with the FN group (0.36 ± 0.28) and PFF group (0.19 ± 0.28) (p < 0.05). Six weeks postoperatively, gait speed improved significantly in all groups (PHF 0.90 ± 0.41; FN 0.72 ± 0.13; PFF 0.60 ± 0.23). Similarly, step length (m) differed between groups postoperatively [FN 0.16 ± 0.13; PFF 0.12 ± 0.15; PHF 0.31 ± 0.05 (p < 0.005)] and improved over time significantly (FN 0.47 ± 0.01; 0.39 ± 0.19; 0.50 ± 0.18). Self-assessment scores indicate that the majority of the patients had minor restrictions in mobility before the fracture. These values decreased immediately postoperatively and improved in the first 6 weeks, but did not reach the initial level | ||
| 520 | |a CONCLUSIONS: Gait speed, step length, and self-assessment in terms of mobility and activities of daily living improve significantly in the first 6 postoperative weeks in orthogeriatric fracture patients. As very low postoperative mobility during hospitalization was observed, this collective shows great potential in postoperative rehabilitation regardless of their fracture pattern. For this reason, specific aftercare concepts similar to the "fast track" concepts in primary arthroplasty are crucial for orthogeriatric patients in clinical practice | ||
| 520 | |a LEVEL OF EVIDENCE: Prospective cohort study, 2 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Gait speed | |
| 650 | 4 | |a Hip fracture rehabilitation | |
| 650 | 4 | |a Physical acticity | |
| 650 | 4 | |a Postoperative mobility | |
| 650 | 4 | |a Proximal femur fracture | |
| 650 | 4 | |a Wearabels | |
| 700 | 1 | |a Holzschuh, Jenny |e verfasserin |4 aut | |
| 700 | 1 | |a Pfeufer, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Gleich, Johannes |e verfasserin |4 aut | |
| 700 | 1 | |a Neuerburg, Carl |e verfasserin |4 aut | |
| 700 | 1 | |a Kammerlander, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Böcker, Wolfgang |e verfasserin |4 aut | |
| 700 | 1 | |a Fürmetz, Julian |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t European journal of trauma and emergency surgery : official publication of the European Trauma Society |d 2012 |g 48(2022), 4 vom: 15. Aug., Seite 2867-2872 |w (DE-627)NLM21794471X |x 1863-9941 |7 nnns |
| 773 | 1 | 8 | |g volume:48 |g year:2022 |g number:4 |g day:15 |g month:08 |g pages:2867-2872 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00068-021-01856-0 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 48 |j 2022 |e 4 |b 15 |c 08 |h 2867-2872 | ||