| 제목 |
The Functional Outcomes of FIRM in Sarcopenic Patients after Hip Fracture : a 6 month of follow-up |
| 소속 |
Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, 1. Department of Physical Medicine and Rehabilitation1, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Department of Rehabilitation Medicine2 |
| 저자 |
Seung-Kyu Lim1*, Jae-Young Lim2† |
Objectives: To compare the change of functional levels for 6 months in both patients with sarcopenia and without sarcopenia who received FIRM after HF surgery, and to identify variables influencing independent ambulation at 6 months after HF
Methods: A prospective observational study was conducted with 80 patients older than 65 years of age who had undergone surgery for HF and followed by multidisciplinary rehabilitation. Sarcopenia was defined according to the Asian Working Group for Sarcopenia criteria. Functional outcomes were measured at rehabilitation admission, at discharge, at 3 months and 6 months after surgery. Main measures were ambulatory function (KOVAL, Functional Ambulatory Category (FAC) and the possibility of independent ambulation (IA) at 6 months after surgery. Other secondary functional outcomes for mobility, balance and fall risk, cognitive function, mood, activities of daily living, frailty and handgrip strength were measured.
Results: Thirty-five patients (43.8%) satisfied the criteria for sarcopenia. KOVAL and FAC improved in all time course by significant time main effect (p<0.001). There were no significant group by time interaction (KOVAL: p=0.889, FAC: p=0.702), and no group main effect (p=0.162) in KOVAL, which means no significant difference in the time course of improvement between groups. Other secondary functional outcomes showed similar improvement patterns in both groups, either. There was no significant difference on the final functional status (6 months) after FIRM compared to non-sarcopenia group in all functional measures. IA before fracture (OR: 4.055) and age (≥80 years) (OR: 0.313) were independent predictors and Sarcopenia was not a predictor for the possibility of IA at 6-months after surgery.
Conclusions: We found that FIRM was effective for functional recovery in older patients with fragility HF even with sarcopenia. Sarcopenia did not affect the possibility of independent ambulation at 6-months after surgery for patients after FIRM. These findings will provide evidence for strong need for comprehensive and integrated rehabilitation management in fragility fracture care to increase functional recovery in patients with sarcopenia.
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Time dependent changes of a) KOVAL and b) FAC between gourps after inpatient rehabilitation (FIRM). Data are means ± standard error. P-values were determined by Two-way repeated measures Two-way ANOVA (treatment and time). * Significant difference between groups by Bonferroni post-hoc test.
Time dependent changes of a) MRMI, b) BBS, c) MBI, d) MMSE, e) EQ5D, f) KIADL, g) GDS, h) KFRAIL and i) Handgrip strength between gourps after inpatient rehabilitation (FIRM). Data are means ± standard error. P-values were determined by Two-way repeated measures ANOVA (treatment and time). * Significant difference between groups by Bonferroni post-hoc test
Predictors for independent ambulation at 6 months after hip fracture surgery : Multivariate analysis
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