Timeline of functional recovery after hip fracture in seniors aged 65 and older: a prospective observational analysis

Abstract

SummaryWe investigated the timeline of functional recovery after hip fracture over 12\xa0months in adults age ≥\u200965\xa0years using objective lower extremity function tests and subjective physical functioning. Objective functional recovery was largely complete in the first 6\xa0months, whereas subjective recovery improved up to 9\xa0months after hip fracture.IntroductionHip fractures are a major cause of loss of function among seniors. We assessed the timeline of objective and subjective functional recovery after hip fracture.MethodsWe conducted a prospective observational secondary analysis of a 1-year clinical trial on vitamin D and home exercise treatment and complications after hip fracture among 173 patients age\u2009≥\u200965\xa0years (mean age 84\xa0years; 79.2% women; 77.4% community-dwelling) conducted from January 2005 through December 2007. Lower extremity function (Timed Up and Go test (TUG), knee extensor and flexor strength) and grip strength was assessed at baseline and at 6 and 12\xa0months follow-up. Subjective physical functioning was assessed using the SF-36 questionnaire also at 3 and 9\xa0months follow-up. Multivariable-adjusted repeated-measures models were used to assess the timeline of functional recovery in the total population and in subgroups of patients.ResultsLower extremity function including TUG (−\u200961.1%), knee extensor (+\u200917.6%), and knee flexor (+\u200911.6%) strength improved significantly in the first 6\xa0months (P\u2009<\u20090.001). However, between 6 and 12\xa0months, there was no further significant improvement for any of the functional tests. Grip strength decreased from baseline to 6\xa0months (−\u20097.9%; P\u2009<\u20090.001) and from 6 to 12\xa0months (−\u200910.8%; P\u2009<\u20090.001). Subjective physical functioning improved from 3 to 9\xa0months (+\u200915.2%, P\u2009<\u20090.001), but no longer thereafter.ConclusionsFunctional recovery after hip fracture may be largely complete in the first 6\xa0months for objective functional tests, whereas may extend up to 9\xa0months for subjective recovery, with oldest-old, female, institutionalized, and cognitively impaired patients recovering most poorly.Clinical trials registry (original trial)NCT00133640.