Clinical Practice Guideline for Postoperative Rehabilitation in Older Patients With Hip Fractures

Annals of Rehabilitation Medicine

Youri Jin¹  Yongsoon Park²  Jung-Yeon Choi³  Myungsook Park⁴  Yonghan Cha⁵  Jun-il Yoo⁶  Bo Ryun Kim⁷  Du Hwan Kim⁸  Seung Don Yoo⁹  Dong Hwan Kim⁹  Yun Jung Lee^1,10  Chang-Hyung Lee^1,11  Seung Yeol Lee^1,12  Donghwi Park^1,13  Hee Seung Yang^1,14  Kyung Hee Do^1,14  Min Cheol Chang^1,15  Myung Chul Kim^1,16  Jae-Young Han^1,17  Jong Geol Do^1,18  Won Kim^1,19  Kyoung Hyo Choi^1,19  Kyunghoon Min^2,20  Heui Je Bang^2,21  JungSoo Lee^2,22  Seoyon Yang^2,23  Jung Hyun Park^2,24  In-Sik Lee^2,25  Ji Sung Yoo^2,26  Sang Yoon Lee^2,27  Jaewon Beom^2,28  Jae-Young Lim^2,28  Ju Seok Ryu^2,28  Goo Joo Lee^2,29  Seong Hoon Lim^3,30  Sun Jae Won^3,31  Il-Young Jang^3,32  In Jong Kim^3,33  Jung Hwan Lee^3,34  In Seok Lee^3,35  Young Jin Song^3,36  Sangwoo Ahn^3,37 

[1] Department of Food and Nutrition Services, Hanyang University Hospital, Seoul, Korea;Department of Food and Nutrition, Hanyang University, Seoul, Korea;Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea;Department of Nursing, Konkuk University, Chungju, Korea;Department of Orthopaedic Surgery, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea;Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, Korea;Department of Physical Medicine and Rehabilitation, Anam Hospital, Korea University College of Medicine, Seoul, Korea;Department of Physical Medicine and Rehabilitation, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea;Department of Physical Medicine and Rehabilitation, Kyung Hee University Hospital at Gangdong, Seoul, Korea;Department of Physical Medicine and Rehabilitation, Myongji Hospital, Goyang, Korea;Department of Physical Medicine and Rehabilitation, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea;Department of Physical Medicine and Rehabilitation, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea;Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea;Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul, Korea;Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, Daegu, Korea;Department of Physical Therapy, Eulji University, Seongnam, Korea;Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea;Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea;Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea;Department of Rehabilitation Medicine, Chungbuk National University College of Medicine, Chungbuk National University Hospital, Cheongju, Korea;Department of Rehabilitation Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea;Department of Rehabilitation Medicine, Ewha Woman’s University Seoul Hospital, Ewha Womans University School of Medicine, Seoul, Korea;Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Korea;Department of Rehabilitation Medicine, Konkuk University School of Medicine and Konkuk University Medical Center, Seoul, Korea;Department of Rehabilitation Medicine, Research Institute and Hospital, National Cancer Center, Goyang, Korea;Department of Rehabilitation Medicine, Seoul National University College of Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea;Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea;Department of Rehabilitation Medicine, Seoul National University Hospital, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea;Department of Rehabilitation Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea;Department of Rehabilitation Medicine, Yeouido Saint Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea;Division of Geriatrics, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;Howareyou Rehabilitation Clinic, Seoul, Korea;Namdarun Rehabilitation Clinic, Yongin, Korea;Nutrition Team, Kyung Hee University Medical Center, Seoul, Korea;Occupational Therapy, Department of Rehabilitation Medicine, Asan Medical Center, Seoul, Korea;Physical Therapy, Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Korea;

关键词: hip fractures;    practice guideline;    rehabilitation;    patient care team;    community health services;   

DOI  :  10.5535/arm.21110

来源: DOAJ

【 摘 要 】

Objective The incidence of hip fractures is increasing worldwide with the aging population, causing a challenge to healthcare systems due to the associated morbidities and high risk of mortality. After hip fractures in frail geriatric patients, existing comorbidities worsen and new complications are prone to occur. Comprehensive rehabilitation is essential for promoting physical function recovery and minimizing complications, which can be achieved through a multidisciplinary approach. Recommendations are required to assist healthcare providers in making decisions on rehabilitation post-surgery. Clinical practice guidelines regarding rehabilitation (physical and occupational therapies) and management of comorbidities/complications in the postoperative phase of hip fractures have not been developed. This guideline aimed to provide evidence-based recommendations for various treatment items required for proper recovery after hip fracture surgeries. Methods Reflecting the complex perspectives associated with rehabilitation post-hip surgeries, 15 key questions (KQs) reflecting the complex perspectives associated with post-hip surgery rehabilitation were categorized into four areas: multidisciplinary, rehabilitation, community-care, and comorbidities/complications. Relevant literature from four databases (PubMed, EMBASE, Cochrane Library, and KoreaMed) was searched for articles published up to February 2020. The evidence level and recommended grade were determined according to the grade of recommendation assessment, development, and evaluation method. Results A multidisciplinary approach, progressive resistance exercises, and balance training are strongly recommended. Early ambulation, weigh-bearing exercises, activities of daily living training, community-level rehabilitation, management of comorbidities/complication prevention, and nutritional support were also suggested. This multidisciplinary approach reduced the total healthcare cost. Conclusion This guideline presents comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery.

【 授权许可】

Unknown