Functional ability before and after rehabilitation in elderly patients with shortening and/or rotational deformity of the lower limb after hip fracture.

ABSTRACT

BACKGROUND: Shortening and rotational deformity of the lower limb (SRD) is a major complication of hip fracture surgery. It causes not only hip joint dysfunction but also functional impairments due to abnormal gait parameters, decreased gait velocity, and poor balance. Despite a number of previous studies, the effect of SRD on the postsurgical recovery of these patients is still not clear. OBJECTIVE: To compare the functional abilities and balance before and after rehabilitation for people with and without SRD after hip fracture surgery and to assess whether SRD affects rehabilitation. DESIGN: Prospective observational study. SETTING: Inpatients of a rehabilitation unit. PARTICIPANTS: A total of 102 people with hip fracture (62 without SRD and 40 with SRD at the time of admission to the unit). MAIN OUTCOME MEASURES: Berg Balance Scale (BBS) and Functional Independence Measure (FIM) motor score, administered before and after rehabilitation. INTERVENTIONS: Motor rehabilitation. RESULTS: Before rehabilitation, patients with SRD had lower motor-FIM (p = .002) and BBS (p = .001) scores than those without SRD. After rehabilitation, both groups showed similar improvements in motor-FIM, BBS, range of motion, muscle strength, and pain scores (p < .001, for all), but patients with SRD still had lower motor-FIM and BBS scores (p = .014 and .003, respectively) and lower effectiveness in motor-FIM and BBS (p = .039 and p = .034, respectively) than those without SRD. CONCLUSIONS: SRD is associated with lower levels of balance and functional abilities before and after rehabilitation and it adversely affects rehabilitation for patients with hip fractures.