Pain and Hip Fracture Outcomes for Older Adults

Feldt, Karen S.; Oh, Heeyoung

doi:10.1097/00006416-200019060-00008

Cited by 60 publications

(70 citation statements)

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“…Younger patients probably have greater self-expectations about ADL/IADL ability and also knowledge of and demand for better pain relief. Perhaps elderly patients are less inclined to complain of postoperative pain and do not tell the staff about it (Feldt and Oh 2000).…”

Section: Discussionmentioning

confidence: 99%

Early individualized postoperative occupational therapy training in 100 patients improves ADL after hip fractureA randomized trial

Hagsten

Svensson

Gardulf

2004

Acta Orthopaedica Scandinavica

126

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BackgroundIt is not clear whether occupational therapy is of value for hip fracture patients.Patients and methods In a randomized trial we studied the effects of an early, individualized, postoperative occupational training (OT) program on the ability of hip fracture patients to perform ADL and IADL. Secondary endpoints were self-reported fear of pain and pain when performing ADL and IADL. The need for technical aids and/or home adaptations was also investigated. 100 eligible patients (aged ≥ 65 years, with independent residence) were randomized 50:50 to an OT or control group (conventional care). During their hospital stay, members of the OT group received individual daily training which included the use of technical aids. Before discharge, the occupational therapist paid a home visit together with the patient. All patients were assessed 2-4 days after surgery, at discharge and after 2 months, using the Klein-Bell ADL scale and a modified version of the Disability Rating Index.Results At discharge, the OT group had better ability to dress, to take care of personal hygiene and bathing activities independently, and to make toilet visits. Age, sex, type of fracture or length of stay at the hospital made no significant contribution to explaining the better ADL ability on discharge. After 2 months, all patients had regained their ADL and IADL abilities. Half of the patients required technical aids and adaptations in their homes.Interpretation Individualized OT-training speed up the ability of patients to perform ADL, thus enhancing the likelihood of patients returning to independent living and reducing the need for postoperative care at home. Hip fracture is a major healthcare problem in terms of cost and suffering (Zethraeus et al. 1997, Haentjens et al. 2001, Tidermark et al. 2002. Most patients are octogenarians and have many other social and medical problems.Intensive, physiotherapy training during the postoperative period improves the functional capacity of the patient (Barnes and Dunovan 1987, Guccione et al. 1996), as this training focuses mainly on the function of various muscle groups that are important for the mobility of the patient. Occupational therapy (OT) training focuses on the activities that are necessary for independent living, i.e., the patientʼs ability to perform the activities of daily living (ADL) and the instrumental activities of daily living (IADL). It has been suggested that hip fracture patients should receive OT training soon after surgery (Kumar and Redford 1984, Thorngren 1991, Byers and Parker 1992, Stewart and McMillan 1998, but there have been no controlled trials of whether this training improves the ADL and IADL abilities of patients faster. We carried out a randomized, controlled trial to study the effects of an early, individualized, post-operative OT training program. Participants and methods PatientsThe hip fracture patients included in the study were treated at the Orthopedic Department of Huddinge University Hospital and were aged ≥ 65 years of age, proficient in Swedish,...

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Section: Discussionmentioning

confidence: 99%

Early individualized postoperative occupational therapy training in 100 patients improves ADL after hip fractureA randomized trial

Hagsten

Svensson

Gardulf

2004

Acta Orthopaedica Scandinavica

126

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“…These studies have revealed shortcomings in the treatment of pain with the consequence that severe pain both at rest and with motion on the first days after the operation delayed early mobilization of the patient, interfered with participation in physical therapy, and led to longer hospital stays (Morrison, 2003). Furthermore, a strong association was found between severe pain in the immediate post-operative phase and higher levels of motor impairment after discharge from hospital, confirmed by other studies (Cree, 2001;Feldt, 2000). The extent to which a previous hipfracture can be a causal factor in chronic pain in the hip joint area has not been sufficiently studied.…”

Section: Hip Fractures and Painmentioning

confidence: 66%

An Evidence-Based Review of Acupuncture in Osteoporosis and Fracture-Related Pain

Mak¹,

Mak²

2011

Acupuncture - Clinical Practice, Particular Techniques and Special Issues

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“…Postoperative pain is thought to be an important predictor for poor functional outcome after THR. 11 Our study groups had low VAS scores at rest and on movement throughout the study period.…”

mentioning

confidence: 61%

La perfusion continue de ropivacaïne à 0,1 % additionnée de 0,5 μg·mL−1 de sufentanil produit une analgésie postopératoire efficace après l’arthroplastie totale de hanche : une étude pilote

Kampe

Kiencke

Delis

et al. 2003

Can J Anesth/J Can Anesth

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Pain and Hip Fracture Outcomes for Older Adults

Cited by 60 publications

References 1 publication

Early individualized postoperative occupational therapy training in 100 patients improves ADL after hip fractureA randomized trial

Early individualized postoperative occupational therapy training in 100 patients improves ADL after hip fractureA randomized trial

An Evidence-Based Review of Acupuncture in Osteoporosis and Fracture-Related Pain

La perfusion continue de ropivacaïne à 0,1 % additionnée de 0,5 μg·mL−1 de sufentanil produit une analgésie postopératoire efficace après l’arthroplastie totale de hanche : une étude pilote

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