Regression-based prognostic models for functional independence after postacute brain injury rehabilitation are not transportable: a systematic review

Pommerich, Uwe Martin; Stubbs, Peter William; Eggertsen, Peter Preben; Fabricius, J; Nielsen, Jørgen Feldbæk

doi:10.1016/j.jclinepi.2023.02.009

Cited by 1 publication

(1 citation statement)

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“…As higher ADL levels are associated with higher physical activity levels in older adults (Amaral Gomes et al., 2021), changes in physical activity should be monitored throughout the hospitalization period. Because the ability of patients with hip fractures to stand and walk is temporarily impaired immediately after surgery (Hofbauer et al., 2021), making it difficult to measure physical activity at the time of rehabilitation admission (Pommerich et al., 2023), the relationship between physical activity at the time of rehabilitation admission and ADL at discharge is unclear. An activity monitor, such as an activity tracker using a triaxial accelerometer, can detect human body movements during the free‐living activities as well as walking (Szeto et al., 2023), allowing continuous sampling of physical activity in older adults with residual ADL disabilities after hip fracture surgery.…”

Section: Introductionmentioning

confidence: 99%

Relationship between independence in activities of daily living at discharge and physical activity at admission of older postoperative hip fracture rehabilitation inpatients: A retrospective case‐control study

Shimizu,

Kanai,

Asakawa

2024

Physiotherapy Res Intl

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Background and PurposeHip fractures are associated with a reduction in activities of daily living (ADL) and require long‐term care. The physical activity of patients with hip fractures is temporarily impaired immediately after surgery, causing difficulty in the measurement of physical activities at the time of rehabilitation admission. This study examined the relationship between ADL at discharge and light‐ and moderate‐intensity physical activity at the time of rehabilitation admission by determining a cut‐off value predicting ADL independence.MethodsThis retrospective case control study analyzed 43 postoperative hip fracture patients aged ≥65 years admitting into inpatient rehabilitation. ADL at discharge was assessed using the Functional Independent Measure motor items (FIM‐m). The duration of physical activity at the time of rehabilitation admission was measured using an activity tracker equipped with an accelerometer. Prehospital frailty was evaluated using Clinical Frailty Scale. The relationship between these variables was examined using Spearman's product‐moment correlation coefficient. Differences in physical activity between patients requiring and not requiring assistance with ADLs were examined using the analysis of covariance. A receiver operating characteristic curve of the need for ADL assistance at discharge was constructed from the duration of physical activity.ResultsThe duration of physical activity at the time of rehabilitation admission was related to FIM‐m at discharge. The cut‐off value of the duration of physical activity for predicting the need for ADL assistance at discharge was 135 s, with a sensitivity of 83.3% and specificity of 68.4% (area under the curve: 0.76).DiscussionThe duration of physical activity at the time of rehabilitation admission may be a factor that can quantitatively predict the risk of requiring assistance with ADLs at discharge in older hip fracture patients. The duration of light‐and‐moderate intensity physical activity may be a component of multidisciplinary inpatient rehabilitation to improve patients' ADL.

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