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Environ Health Prev Med (2009) 14:188195 DOI 10.1007/s12199-009-0079-8
REGULAR ARTICLE
Early prediction of gait ability in patients with hip fracture
Eiki Tsushima Ryukichi Hada Manabu Iwata Hitoshi Tsushima
Received: 6 July 2008 / Accepted: 19 January 2009 / Published online: 27 March 2009 The Japanese Society for Hygiene 2009
AbstractObjective Many elderly patients with hip fracture (HF) present with gait decits. As such, an HF both indirectly and directly increases the number of elderly people requiring care, making it a major medical and economic problem in an aging society. To facilitate the treatment of HF and attempt to resolve the consequences, we have attempted to derive an equation that would predict gait ability. The prediction equation was developed by multivariate analysis using standard evaluation methods, with inclusion of guaranteed objectivity where possible. We attached greater importance to the prediction of gait ability early in the period of hospitalization, since this allows for early determination of an efcient therapeutic strategy. Methods The subjects were 54 HF patients (six men, 48 women; mean age: 78.0 8.4 years) admitted to general hospitals in Hirosaki, Aomori prefecture, between 1998 and 2007. All were aged 60 years or older and were able to walk immediately before injury; physical therapy was initiated for all individuals during hospitalization. Evaluation items related to physical function, psychological function, and complications that may affect gait were evaluated; these included the manual muscle test, motor age test, Katzs index, dementia (HDS-R), consciousness disturbance, among others.
Results Based on data for 35 patients who could gait at discharge and 19 patients who could not, a model including MAT, HDS-R, and the New York Heart Association classication of cardiac function scores (P \ 0.001) was obtained using multiple logistic regression analysis (discriminant hitting ratio: 94.4%).
Conclusions The effectiveness of the derived model suggests that both physical and psychological functions should be considered for gait prediction.
Keywords Assessment of functional state
Gait on discharge Hip fracture Physical therapy
Prediction of gait ability
Introduction
Many elderly patients with hip fracture (HF) present with gait decits. As such, an HF both indirectly and directly increases the number of elderly people requiring care, making this condition a major medical and economic problem in an aging society. Major factors that affect the prognosis...