No rest for the wounded: early ambulation after hip surgery accelerates recovery
| Autor: | Michael Bailey, Val J. Robertson, Elton R Edwards, Leonie B. Oldmeadow, Eva Kipen, Lara A Kimmel |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Randomization Time Factors Walking law.invention Randomized controlled trial law Acute care Early ambulation medicine Humans Orthopedic Procedures Range of Motion Articular Physical Therapy Modalities Aged Retrospective Studies Hip surgery Aged 80 and over Hip fracture business.industry Hip Fractures Retrospective cohort study General Medicine Recovery of Function Middle Aged medicine.disease Treatment Outcome Physical therapy Surgery Female Hip Joint business Range of motion Follow-Up Studies |
| Zdroj: | ANZ journal of surgery. 76(7) |
| ISSN: | 1445-1433 |
| Popis: | Background: Level 3 evidence-based guidelines recommend first walk after hip fracture surgery within 48 h. Early mobilization is resource and effort intensive and needs rigorous investigation to justify implementation. This study uses a prospective randomized method to investigate the effect of early ambulation (EA) after hip fracture surgery on patient and hospital outcomes. Methods: Sixty patients (41 women and 19 men; mean age 79.4 years) admitted between March 2004 through December 2004 to The Alfred Hospital, Melbourne, for surgical management of a hip fracture were studied. Randomization was either EA (first walk postoperative day 1 or 2) or delayed ambulation (DA) (first walk postoperative day 3 or 4). Functional levels on day 7 post-surgery, acute hospital length of stay and destination at discharge were compared. Results: At 1 week post-surgery, patients in the EA group walked further than those in the DA group (P = 0.03) and required less assistance to transfer (P = 0.009) and negotiate a step (P = 0.23). Patients in the EA group were more likely to be discharged directly home from the acute care than those in the DA group (26.3 compared with 2.4%) and less likely to need high-level care (36.8 compared with 56%). A failed early ambulation subgroup had significantly more postoperative cardiovascular instability and worse results for all outcome measures. Conclusion: EA after hip fracture surgery accelerates functional recovery and is associated with more discharges directly home and less to high-level care. |
| Databáze: | OpenAIRE |
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