A Pilot Investigation of the Short‐Term Effects of an Interdisciplinary Intervention Program on Elderly Patients with Hip Fracture in Taiwan

Shyu, Yea‐Ing Lotus; Liang, Jersey; Wu, Chin‐Chen; Su, Juin Yih; Cheng, Huey Shinn; Chou, Shih‐Wei; Yang, Ching Tzu

doi:10.1111/j.1532-5415.2005.53253.x

Cited by 97 publications

(135 citation statements)

References 31 publications

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“…Their reviews were inconclusive because of the heterogeneity across the studies reviewed. In contrast, a systematic review 22 and RCTs [23][24][25] of interdisciplinary inpatient geriatric rehabilitation for adults with hip fractures have shown benefits of discharge to home, improved physical function at 6 and 12 months, and increased survival rates at 6 months as a result of programs directed by rehabilitation physicians, geriatric nurses, and physical therapists.…”

Section: Summary Of Findings On Efficacymentioning

confidence: 97%

Effectiveness of Multidisciplinary Rehabilitation Services in Postacute Care: State-of-the-Science. A Review

Bettger

Stineman

2007

Archives of Physical Medicine and Rehabilitation

137

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Objectives-To summarize the efficacy of postacute rehabilitation and to outline future research strategies for increasing knowledge of its effectiveness.Data Sources-English-language systematic reviews that examined multidisciplinary therapybased rehabilitation services for adults, published in the last 25 years and available through Cochrane, Medline, or CINAHL databases. We excluded multidisciplinary biopsychosocial rehabilitation programs and mental health services.Study Selection-Using the search term rehabilitation, 167 records were identified in the Cochrane database, 1163 meta-analyses and reviews were identified in Medline, and 226 in CINAHL. The Medline and CINAHL search was further refined with 3 additional search terms: therapy, multidisciplinary, and interdisciplinary. In summary, we used 12 reviews to summarize the efficacy of multidisciplinary, therapy-based postacute rehabilitation; the 12 covered only 5 populations.Data Extraction-Two reviewers extracted information about study populations, sample sizes, study designs, the settings and timing of rehabilitation, interventions, and findings.Data Synthesis-Based on systematic reviews, the evidence for efficacy of postacute rehabilitation services across the continuum was strongest for stroke. There was also strong evidence supporting multidisciplinary inpatient rehabilitation for patients with rheumatoid arthritis, moderate to severe acquired brain injury, including traumatic etiologies, and for older adults. Heterogeneity limited our ability to conclude a benefit or a lack of a benefit for rehabilitation in other postacute settings for the other conditions in which systematic reviews had been completed. The efficacy of multidisciplinary rehabilitation services has not been systematically reviewed for many of the diagnostic conditions treated in rehabilitation. We did not complete a summary of findings from individual studies.Conclusions-Given the limitations and paucity of systematic reviews, information from carefully designed nonrandomized studies could be used to complement randomized controlled No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated. The pressure on providers of postacute rehabilitation to deliver clinically effective care will only intensify as cost-containment efforts and requirements for documenting the quality of care increase. Systematically acquired evidence can guide rehabilitation services toward higher quality, effective and cost-efficient care; however, the evidence for certain conditions and rehabilitation settings is better developed than for others. More clearly delineating the evidence of effectiveness will help determine whether certain postacute rehabilitation services produce better outcomes than alternatives. Subsequently, policy-makers, health care administrators, and clinicians might be better informed for making decisions about prov...

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Section: Summary Of Findings On Efficacymentioning

confidence: 97%

Effectiveness of Multidisciplinary Rehabilitation Services in Postacute Care: State-of-the-Science. A Review

Bettger

Stineman

2007

Archives of Physical Medicine and Rehabilitation

137

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“…Published literature has shown mixed outcomes on perioperative morbidity and mortality with medical comanagement of patients [29,49,78,91,104]. Some recent literature has demonstrated improved patient outcomes using a patient-centered protocol-driven care approach to patients with hip fracture [28,29].…”

Section: Preoperative Assessment and Preparation For Surgerymentioning

confidence: 99%

Short-term and Long-term Orthopaedic Issues in Patients With Fragility Fractures

Bukata

Kates

O’Keefe

2011

Clinical Orthopaedics &Amp; Related Research

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Background Patients with impaired bone quality who suffer a fragility fracture face substantial challenges in both their short-and long-term care. In addition to poor bone quality, many of these patients have multiple medical comorbidities that alter their surgical risk and affect their ultimate functional recovery. Some medical issues can contribute to the altered bone quality and must be addressed to prevent future fractures. Questions/purposes This review summarizes the modifications in perioperative management and fracture fixation in patients with common fragility fractures who have impaired bone quality. It also summarizes the postoperative diagnosis and treatment of secondary causes of impaired bone quality in these patients. Methods We performed a PubMed search, and literature published after 2000 was prioritized, with the exception of benchmark clinical trial studies published before 2000. Results Patients with altered bone quality require rapid perioperative management of multiple medical comorbidities. Implant selection in patients with poor quality bone should permit early weightbearing, and constructs should maximize surface area contact with the remaining bone. Long-term diagnosis and treatment of other disease states contributing to poor bone quality (vitamin D deficiency/ insufficiency, hypothyroidism, hyperthyroidism, hyperparathyroidism, Cushing's disease, and hypogonadism) must occur to minimize the chances of future fractures. Conclusions Recognition of patients with impaired bone quality and proper treatment of their special needs in both the short and long term are essential for their best opportunity for maximal functional recovery and prevention of future fractures.

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“…These patients with CI are more prone than other hip fracture patients to delirium (Inouye and Charpentier, 1996), longer lengths of acute hospital stays (Wells et al, 2004), and mortality (Koot et al, 2000). A literature review of 21 studies from eight countries reported that hip fracture patients with CI can benefit from participating in rehabilitation targeted at improving self-care and motor function (Magaziner et al, 1990;Cummings et al, 1996;Patrick et al, 1996;Goldstein et al, 1997;Heruti et al, 1999;Naglie et al, 2002;Adunsky et al, 2002;Hoenig et al, 2002;Gruber-Baldini et al, 2003;Barnes et al, 2004;Lenze et al, 2004;Rolland et al, 2004;Arinzon et al, 2005;Haentjens et al, 2005;Shyu et al, 2005;Bitsch et al, 2006;GTA Rehab Network, 2006;Lieberman et al, 2006;Moncada et al, 2006;Wells et al, 2006;Yu et al, 2006).…”

Section: Rehabilitation Of Patients With CI Following Hip Fracturementioning

confidence: 99%

“…These include the following: age (Arinzon et al, 2005); sex (Rolland et al, 2004); pre-fracture cognitive function (Gruber-Baldini et al, 2003); pre-fracture functional status (Cummings et al, 1996;Naglie et al, 2002;Moncada et al, 2006); medical co-morbidities (Patrick et al, 1996(Patrick et al, , 2002; pre-fracture frailty (Arinzon et al, 2005); sensory (hearing and vision) impairment (Rolland et al, 2004); nutritional status (Lieberman et al, 2006); social support (Beaupre et al, 2005); depression (Goldstein et al, 1997;Lenze et al, 2004;Shyu et al, 2005); and delirium or incident CI (Adunsky et al, 2002;Gruber-Baldini et al, 2003;Bitsch et al, 2006).…”

Section: Patient Characteristicsmentioning

confidence: 99%

Outcomes for older adults in an inpatient rehabilitation facility following hip fracture (HF) surgery

McGilton

Mahomed

Davis

et al. 2009

Archives of Gerontology and Geriatrics

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The purpose of the study was to evaluate patient and system outcomes regarding older community-residing adults who participated in a rehabilitation program following hip fracture surgery. The health care professionals on the rehabilitation unit in this feasibility study had never cared for such patients who were so frail, with multiple co-morbidities including cognitive impairment (CI). After an innovative model of care was developed and the staff trained in the novel approach to care, the unit opened for all clients living within the community who had fractured their hip, regardless of their cognitive impairment. Of the 31 elderly patients consecutively admitted post hip fracture in this retrospective study, 18were found to have CI postoperatively as determined by a Mini-Mental State Examination score < 23. There were no difference in length of stay, rehabilitation efficiency, and motor FIM gain scores between the two groups of patients. This feasibility retrospective study study suggests that staff can learn how to care for clients with cognitive impairment in rehabilitation settings, and that such clients can achieve outcomes comparable to those without CI in a setting dedicated to caring for patients with a hip fracture.1

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A Pilot Investigation of the Short‐Term Effects of an Interdisciplinary Intervention Program on Elderly Patients with Hip Fracture in Taiwan

Abstract: This intervention program may benefit older people with hip fractures in Taiwan by improving their clinical outcomes, self-care abilities, and HRQOL and by decreasing depressive symptoms within 3 months after discharge.

Cited by 97 publications

References 31 publications

Effectiveness of Multidisciplinary Rehabilitation Services in Postacute Care: State-of-the-Science. A Review

Effectiveness of Multidisciplinary Rehabilitation Services in Postacute Care: State-of-the-Science. A Review

Short-term and Long-term Orthopaedic Issues in Patients With Fragility Fractures

Outcomes for older adults in an inpatient rehabilitation facility following hip fracture (HF) surgery

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