Timeline of functional recovery after hip fracture in seniors aged 65 and older: a prospective observational analysis.

Abstract

Hip fractures are a major cause of loss of function among seniors. We assessed the timeline of objective and subjective functional recovery after hip fracture. We conducted a prospective observational secondary analysis of a 1-year clinical trial on vitamin D and home exercise treatment and complications after hip fracture among 173 patients age ≥ 65years (mean age 84years; 79.2% women; 77.4% community-dwelling) conducted from January 2005 through December 2007. Lower extremity function (Timed Up and Go test (TUG), knee extensor and flexor strength) and grip strength was assessed at baseline and at 6 and 12months follow-up. Subjective physical functioning was assessed using the SF-36 questionnaire also at 3 and 9months follow-up. Multivariable-adjusted repeated-measures models were used to assess the timeline of functional recovery in the total population and in subgroups of patients. Lower extremity function including TUG (- 61.1%), knee extensor (+ 17.6%), and knee flexor (+ 11.6%) strength improved significantly in the first 6months (P < 0.001). However, between 6 and 12months, there was no further significant improvement for any of the functional tests. Grip strength decreased from baseline to 6months (- 7.9%; P < 0.001) and from 6 to 12months (- 10.8%; P < 0.001). Subjective physical functioning improved from 3 to 9months (+ 15.2%, P < 0.001), but no longer thereafter. Functional recovery after hip fracture may be largely complete in the first 6months for objective functional tests, whereas may extend up to 9months for subjective recovery, with oldest-old, female, institutionalized, and cognitively impaired patients recovering most poorly. NCT00133640.