The impact of previous strokes on the rehabilitation of elderly patients sustaining a hip fracture

Arch Phys Med Rehabil. 2007 Sep;88(9):1136-9. doi: 10.1016/j.apmr.2007.05.029.

Abstract

Objective: To evaluate whether a previous stroke may affect the functional outcome gain of elderly patients undergoing rehabilitation for a hip fracture.

Design: A retrospective cohort study.

Setting: The division of geriatric medicine with rehabilitation wards at a university-affiliated referral hospital.

Participants: Patients with hip fractures (N=460) undergoing a standard rehabilitation course.

Interventions: Not applicable.

Main outcome measures: The functional outcome of previous stroke- and nonprevious stroke (NPS)-affected patients assessed by the FIM instrument at admission and discharge from the rehabilitation facility. Data were analyzed by t tests, Pearson correlation, chi-square tests, and linear regression analysis.

Results: Both admission and discharge total FIM scores were significantly higher in NPS compared with previous stroke patients (63.53+/-19.89 vs 52.19+/-19.37, P<.001) and (84.23+/-24.93 vs 71.37+/-25.03, P=.001), respectively. However, changes in total FIM (20.70+/-11.68 vs 19.17+/-13.32, P=.38) and in motor FIM (19.84+/-10.63 vs 17.96+/-11.21, P=.23) at discharge were not statistically significant between the 2 groups. A linear regression analysis showed that a previous stroke was not predictive of a worse total FIM gain at discharge (P=.58).

Conclusions: NPS hip fracture elderly patients show higher admission and discharge FIM scores compared with previous stroke patients. Nevertheless, both groups achieve similar FIM gains during rehabilitation period. A previous stroke should not be considered as adversely affecting the rehabilitation of such patients.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Disability Evaluation*
  • Female
  • Follow-Up Studies
  • Hip Fractures / complications
  • Hip Fractures / physiopathology
  • Hip Fractures / rehabilitation*
  • Humans
  • Male
  • Middle Aged
  • Motor Activity / physiology*
  • Patient Admission / statistics & numerical data
  • Patient Discharge / statistics & numerical data
  • Prevalence
  • Retrospective Studies
  • Stroke / complications*
  • Stroke / epidemiology
  • Stroke / physiopathology
  • Treatment Outcome
  • United States / epidemiology