232 / 245
232
· DOS Abstracts
Fatigue and pain limits independent mobility and
physiotherapy after hip fracture surgery
Kristine HusumMünter, Christopher Clemmesen , Nicolai Bang Foss, Henrik Palm,
Morten Tange Kristensen
Anaesthesiology, Hvidovre Hospital; Orthopaedic Surgery, Hvidovre Hospital;
Physiotherapy, Hvidovre Hospital
Background:
The patient’s ability to complete their planned physiotherapy
session after hip fracture (HF) surgery has been proposed as an independent
predictor for achieving basic mobility independency upon hospital discharge.
However, knowledge of factors limiting is sparse.
Purpose / Aim of Study:
To examine patient reported factors limiting ability to
complete planned physiotherapy sessions as well as limitations for not achieving
independency in basic mobility early after HF surgery.
Materials and Methods:
204 consecutive patients with a HF (47 admitted
from a nursing home); mean age of 80 years, and treated in accordance with
a multimodal enhanced program. The Cumulated Ambulation Score (CAS) was
used to evaluate the patient’s independency in three basic mobility activities:
getting in and out of bed, sit-to-stand-to-sit from a chair with arms and indoor
walking with an aid. Limitations for patients not achieving a full CAS score or
inability to complete their planned physiotherapy sessions were noted by physi-
otherapists on postoperative day 1-3.
Findings / Results:
More than 85% and 42% of patients, respectively, did
not achieve an independent CAS level and did not fully complete their planned
physiotherapy on all three days, and with fatigue and hip fracture-related pain
as the most frequent reported reasons. At hospital discharge (median [IQR] day
10 [6-14]), only 54% of patients had regained their pre-fracture CAS level.
Conclusions:
Based on the patient’s perception, fatigue and pain are the most
frequent limitations for patients not achieving independent basic mobility and
not completing physiotherapy, early after hip fracture surgery, despite follow-
ing an enhanced recovery program. This raises questions whether multimodal
perioperative hip fracture programs can be further optimized to enhance the
early recovery of these frail patients.
No conflicts of interest reported
183.