The Effect of Rehabilitation in Hip and Knee Proprioception in Older Adults Following Hip Fracture

Abstract

1010 Ongoing risk of falls and disability following hip fracture may involve proprioceptive deficits. PURPOSE: To determine the effect of post-surgical rehabilitation on proprioception in the hip and knee joints of patients with hip fracture on discharge from an inpatient hip fracture rehabilitation program. METHODS: Proprioception (Biometrics Ltd. electrogoniometer) was assessed within 48 h of admission and 48 h before discharge. The passive to active reproduction of joint angle technique was performed to determine absolute angular error (AAE) in non-weight-bearing positions at 15°, 30°, and 60° of hip flexion and knee extension in both the injured and non-injured sides. Data were collected on 30 hip fracture patients (3 men, 27 women; mean age 80 ± 7 y, range 66–94 y) who attended physiotherapy and occupational therapy sessions 5 times/week during a mean rehabilitation hospital length of stay of 25 ± 8 days. RESULTS: On admission, there was a significant difference in AAE between the injured and non-injured hips indicating that the hip fracture affected hip joint proprioception. There was a significant (p < .05) decrease in AAE from admission (5.3 ± 2.6°; 4.1 ± 3.1°) to discharge (3.0 ± 2.3°; 2.8 ± 3.1°) in hip flexion and knee extension, respectively, on the injured side. The magnitude of the AAE was significantly different (p < .05) at 15° compared to 30° and 60° angles in both hip flexion and knee extension at admission and discharge on the injured side. CONCLUSION: The rehabilitation program was focused on strengthening, balance, and gait retraining, all of which contribute to mobility and may indirectly improve proprioception. Hip and knee joint proprioception significantly improved in the injured side after the program.