Effectiveness of Post-Acute Rehabilitation on Functional Outcome after Hip Fracture

急性後期復健對於髖關節骨折術後功能恢復的功效

王燕如(Yen-Ju Wang) ； 林佩欣(Pei-Hsin Lin) ； 彭莉甯(Li-Ning Peng) ； 高木榮(Mu-Jung Kao) ； 林語蓁(Serena Y.C Lin) ； 黃冠樺(Kuan-Hua Huang) ； 陳彥方(Yen-Fang Chen) ； 梁妙如(Miao-Ru Liang)

《台灣復健醫學雜誌》 47卷1期 (2019/06) Pp. 11-20

https://doi.org/10.6315/TJPMR.201906_47(1).0002

摘要

Objective: We investigated the effectiveness of functional recovery after 2-week post-acute rehabilitation in elderly people with hip fractures. Design: We divided the patients (N = 129) into 2 groups: the post-acute care (PAC) group (N = 90) that received 2-week in-hospital rehabilitation and the control group (N =39) that were discharged immediately. Outcomes were measured according to the Barthel Index (BI) score. Results: The BI scores at 2 weeks, 3 months, and 6 months were higher in the PAC group than those in the control group, especially for transfer and mobility. Males, aged less than 80 years old, or who had received hemiarthroplasty showed more improvement than that of the other patients. Patients with moderate initial functional status showed the most improvement after receiving the PAC program. All patients in the control group showed decreased BI scores after discharge. Conclusion: Functional recovery in patients with hip fracture was significantly better in the PAC group, especially for ambulation and transfer.

關鍵字

BartheI Index ； hip fracture ； outcome ； post-acute care ； rehabilitation

並列摘要

目的：本篇主要研究老年人的髖關節骨折經過兩週的急性後期復健訓練後的功能恢復。研究設計：我們將129位病人分成兩組：一組為急性後期照護組（90位），將接受兩週的住院復健訓練；另一組為控制組（39位）為立即出院，利用巴氏量表分數來評估結果。結果：研究發現在第二週，第三個月與第六個月追蹤的巴氏量表分數，急性後期照護組比起控制組的分數較高，特別是在轉位與平地行走的部分。此外，男性、年紀小於80歲或接受半人工髖關節置換術（hemiarthroplasty）的病人有更多的進步。起始是中等的功能狀態的病人，在接受急性後期復健訓練後有最大的功能進步。所有控制組的病人在追蹤過程的巴氏量表分數都變差。結論：接受急性後期復健訓練的髖關節骨折病人，比起控制組有顯著的功能恢復，特別是在轉位與行走的表現。

並列關鍵字

巴氏量表分數（BartheI index） ； 髖關節骨折（hip fracture） ； 結果（outcome） ； 急性後期照護（post-acute care） ； 復健（rehabilitation）

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