TY - JOUR
T1 - Influence of Rehabilitation Site on Hip Fracture Recovery in Community-Dwelling Subjects at 6-Month Follow-Up
AU - Munin, Michael C.
AU - Begley, Amy
AU - Skidmore, Elizabeth R.
AU - Lenze, Eric J.
N1 - Funding Information:
Supported by the National Institutes of Health (grant nos. R21 HD043202, K23 MH64196).
PY - 2006/7
Y1 - 2006/7
N2 - Munin MC, Begley A, Skidmore ER, Lenze EJ. Influence of rehabilitation site on hip fracture recovery in community-dwelling subjects at 6-month follow-up. Objective: To evaluate whether postacute rehabilitation after hip fracture influences recovery of prefracture function as detected by the FIM instrument motor scale. Design: Inception cohort. Setting: University-affiliated tertiary care hospital; inpatient rehabilitation facilities (IRFs) or skilled nursing facilities (SNFs). Participants: People with acute proximal femur fracture treated between March 1, 2002, and June 30, 2003. Intervention: Post-hip fracture rehabilitation delivered at an IRF or SNF. Main Outcome Measure: FIM motor score estimated prefracture and obtained at 2 weeks and 24 weeks after hospital discharge. Results: Fifty-eight patients were treated at an IRF, whereas 39 were treated at an SNF. Controlling for baseline covariates, a mixed model showed a significant group by time interaction (F3,57.1=14.27, P<.001). Contrasts indicated that IRF subjects had greater initial improvement. Multiple logistic regression examining factors associated with recovery of FIM motor score to 95% or more of prefracture FIM motor score by 24 weeks found that IRF setting only was associated with recovery of baseline function with odds ratio of 5.44 (95% confidence interval, 2.02-14.65). Conclusions: Even when controlling for important baseline covariates, community-dwelling hip fracture subjects treated in an IRF are more likely to attain 95% or more of prefracture functional status by 24 weeks postdischarge than subjects treated in an SNF.
AB - Munin MC, Begley A, Skidmore ER, Lenze EJ. Influence of rehabilitation site on hip fracture recovery in community-dwelling subjects at 6-month follow-up. Objective: To evaluate whether postacute rehabilitation after hip fracture influences recovery of prefracture function as detected by the FIM instrument motor scale. Design: Inception cohort. Setting: University-affiliated tertiary care hospital; inpatient rehabilitation facilities (IRFs) or skilled nursing facilities (SNFs). Participants: People with acute proximal femur fracture treated between March 1, 2002, and June 30, 2003. Intervention: Post-hip fracture rehabilitation delivered at an IRF or SNF. Main Outcome Measure: FIM motor score estimated prefracture and obtained at 2 weeks and 24 weeks after hospital discharge. Results: Fifty-eight patients were treated at an IRF, whereas 39 were treated at an SNF. Controlling for baseline covariates, a mixed model showed a significant group by time interaction (F3,57.1=14.27, P<.001). Contrasts indicated that IRF subjects had greater initial improvement. Multiple logistic regression examining factors associated with recovery of FIM motor score to 95% or more of prefracture FIM motor score by 24 weeks found that IRF setting only was associated with recovery of baseline function with odds ratio of 5.44 (95% confidence interval, 2.02-14.65). Conclusions: Even when controlling for important baseline covariates, community-dwelling hip fracture subjects treated in an IRF are more likely to attain 95% or more of prefracture functional status by 24 weeks postdischarge than subjects treated in an SNF.
KW - Hip fractures
KW - Rehabilitation
KW - Skilled nursing facilities
UR - http://www.scopus.com/inward/record.url?scp=33745258682&partnerID=8YFLogxK
U2 - 10.1016/j.apmr.2006.04.002
DO - 10.1016/j.apmr.2006.04.002
M3 - Article
C2 - 16813791
AN - SCOPUS:33745258682
VL - 87
SP - 1004
EP - 1006
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
SN - 0003-9993
IS - 7
ER -