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大学・研究所にある論文を検索できる 「The association between early rehabilitation and ambulatory ability at discharge in patients with hip fractures at acute-phase rehabilitation wards: a survey of the Japan Association of Rehabilitation Database」の論文概要。リケラボ論文検索は、全国の大学リポジトリにある学位論文・教授論文を一括検索できる論文検索サービスです。
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The association between early rehabilitation and ambulatory ability at discharge in patients with hip fractures at acute-phase rehabilitation wards: a survey of the Japan Association of Rehabilitation Database

Hattori, Koji Kamitani, Hiroko Suzuki, Yusuke Shiraishi, Nariaki Hayashi, Takahiro Matsumoto, Daisuke Sugiyama, Motoya Komiya, Hitoshi Kuzuya, Masafumi 名古屋大学

2023.08

概要

A 2012 survey conducted in Japan reported an estimated 175,700 new patients with femoral
neck fractures, which represents a 3.3-fold increase since 1987.1 With an increasing incidence,
40–50% of patients with femoral neck fractures are not able to return to their pre-injury
independence in activities of daily living (ADLs).2,3 Eventually, the constant rise in the number
of post-fracture bedridden older patients warrants the need for greater caregiving measures and
resources, making it a major problem for the current super-aged Japanese society. The number of
patients with femoral neck fracture is projected to increase worldwide, which has resulted in rising concerns regarding the need for competent rehabilitation to achieve functional independence.4,5
Many reports concerning the prognosis of patients with a femoral neck fracture support the
use of early surgical interventions after injury (within 24 hours to 4 days) in terms of reduced
complications, increased survival rates, and shortened hospital stay. 6,7 However, only a few
studies have elucidated the effects of early rehabilitation, with only one of them focusing on
the effect of the clinical pathway.8 Among the limited evidence highlighting the effects of early
rehabilitation, a four-month-long observational study by March et al compared patients who were
not introduced to a clinical pathway (mobilization within 48 hours) (n = 455) to those who
were (n = 481) and reported that the latter had a reduced hospital length of stay from 11 days
to 9 days.9 Likewise, Tallis et al also reported positive effects of an early mobilization program
(from postoperative day 1) in terms of reduced length of hospital stay from 19.3 days to 11
days in patients aged > 50 years. Under this program, the start of postoperative mobilization,
ie, the number of days between the operation and walking for the first time, was preponed by
a day (from 4.3 days to 3.0 days).10
So far, the literature supporting the effects of early rehabilitation after femoral neck fractures
remains indeterminate about two crucial aspects. First, there is insufficient evidence focusing on
the relationship between early rehabilitation and the recovery of physical function, especially
gait.11 Second, most reports have relied on data from single facilities, limiting the generalizability
and external validity of these findings.
Therefore, in the present study, we used a multi-facility participatory database to investigate the
relationship between early rehabilitation and the improvement in ambulatory ability at discharge
in older patients who had sustained femoral neck fractures. ...

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参考文献

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Nagoya J. Med. Sci. 85. 455–464, 2023

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doi:10.18999/nagjms.85.3.455

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