Measurement of Function Post Hip Fracture: Testing a Comprehensive Measurement Model of Physical Function

Abstract

Background Measurement of physical function post hip fracture has been conceptualized using multiple different measures. Purpose This study tested a comprehensive measurement model of physical function. Design This was a descriptive secondary data analysis including 168 men and 171 women post hip fracture. Methods Using structural equation modeling, a measurement model of physical function which included grip strength, activities of daily living, instrumental activities of daily living and performance was tested for fit at 2 and 12 months post hip fracture and among male and female participants and validity of the measurement model of physical function was evaluated based on how well the model explained physical activity, exercise and social activities post hip fracture. Findings The measurement model of physical function fit the data. The amount of variance the model or individual factors of the model explained varied depending on the activity. Conclusion Decisions about the ideal way in which to measure physical function should be based on outcomes considered and participant Clinical Implications The measurement model of physical function is a reliable and valid method to comprehensively measure physical function across the hip fracture recovery trajectory. Practical but useful assessment of function should be considered and monitored over the recovery trajectory post hip fracture.

Healthcare professionals’ perspectives on rehabilitating persons with cognitive impairment

“…Learning how to engage person with CI in rehabilitation has been described as vital (Isbel & Jamieson et al, 2017). Additional strategies used by Resnick et al (2016aResnick et al ( , 2016b included developing tailored rehabilitation approaches that address behavioral and psychological symptoms associated with CI which include: focusing on the successful performance of the activity, providing verbal encouragement, seeing other patients perform the activity as a potential way to cue the patient, and elimination of unpleasant physiological and affective states associated with the activity. Understanding the underlying causes for delirium and trying to mitigate those factors were also essential as was differentiating between delirium and dementia.…”

“…Studies are slowly surfacing which detail models being implemented to rehabilitate persons with dementia post-hip fracture surgery to improve their outcomes (Resnick et al, 2016a(Resnick et al, , 2016b. These models include similar characteristics: an interdisciplinary team to address psychosocial factors, use of assistive devices, prevention and treatment of delirium, and innovative approaches to engage individuals with CI.…”

“…Recovery following a hip fracture for community-dwelling older adults may be complicated by cognitive impairment (CI) ( Lundstrom et al, 2003 ) commonly presented as dementia and/or delirium ( Resnick et al, 2016a , 2016b ). It is estimated that 23.9–83.5% of older adults with a hip fracture have dementia ( Seitz et al, 2014a , 2014b ) and about 48% of older adults experience delirium ( Zyweil et al, 2015 ).…”

“…However, some clinicians believe persons with CI can be rehabilitated and that cognitive status alone should not be used as a criterion for access to rehabilitation ( Isbel & Jamieson, 2017 ). Older adults with CI who gain access can benefit from intensive rehabilitation programs ( McGilton et al, 2013 ; Resnick et al, 2016a , 2016b ) with positive impacts such as a lower risks of falls ( Seitz et al, 2016 ), gains in physical function ( McGilton et al, 2012 ), and decreased risk of long-term care placement ( Seitz et al, 2016 ; Smith et al, 2015 ).…”

Κάταγμα Ισχίου Στους Ηλικιωμένους Στην Ελλάδα

“…Αν και είναι δύσκολο να μετρηθεί, είναι σημαντικό να γίνεται σαφής και συνεπής σύλληψη της φυσικής λειτουργίας μετά το κάταγμα, καθώς είναι το μέτρο που χρησιμοποιείται για την κατανομή πόρων, όπως το προσωπικό που χρειάζεται για να παρέχει φροντίδα, τον καθορισμό του επιπέδου φροντίδας που απαιτείται (σύγκριση αποτελεσματικότητας διαφόρων τύπων παρεμβάσεων: προγράμματα άσκησης, παρεμβάσεις νοσηλευτικής φροντίδας κλπ) και την καθοδήγηση των ασθενών και φροντιστών στην τροχιά ανάρρωσης (Allen et al, 2012). Η φυσική λειτουργία μπορεί να οριστεί ως η ικανότητα να εκτελούνται διάφορες δραστηριότητες που απαιτούν σωματική ικανότητα, από τις BADL έως πιο έντονες δραστηριότητες που απαιτούν αυξημένους βαθμούς κινητικότητας και αντοχής (Resnick et al, 2015).…”