Effect of balneo-physical therapy on quality of life of patients with surgically treated hip

Hip fractures in geriatrics are a major health problem, both for individuals and for the entire health care system. It is estimated that only half of those patients who were completely independent before fracture, becomes able to walk without aids, and even one-fifth must be permanently placed in institutions for the care of the elderly. The aim of this study was to determine the efficacy of the applied rehabilitaion proram on the recovery of patients older than 65 years after surgically treated hip fracture and to compare the effects of different rehabilitation programs. This prospective study was conducted on 203 patients admited on rehabilitation after operated hip fracture. Input parameters were gender, age, type of fracture, type of surgery, time since surgery and start of rehabilitation, duration of rehabilitation and comorbidity measured by Cumulative Illnese Rating Score for Geriatrics (CIRS-G). Functional recovery was evaluated by Berg Balance Scale (BBS) and the motor part of Functional Independance Measure (FIM). The quality of life was evaluated by SF-36v2 Health Survey. Values were recorded at admission, at discharge, 3 and 6 months after discharge. Patients were divided into two groups, one group that was treated in the rehabilitation program including balneotherapy and Group 2, in which the patients were treated without balneotherapy. The type of rehabilitation program determined the treating physician specialis of phzsical medicine and rehabilitation. Statistical analysis was preformed using Student's t test, Mann-Whitney U test, unifactorial ANOVA test, Pearson correlation. The results showed that all patients had a statistically significant improvement in functional recovery measured by the BBS and a motor FIM at discharge, and that this improvement took place, and after 3 and 6 months. Patients in group 1 showen at admission, discharge, and after 3 and 6 months statistically significantly better resoults than patients in group 2. Considering that the two groups except for the type of rehabilitation treatment differed according to the degree of co-morbidity (patients in Group 1 had fewer associated diseases) and by age (patients in Group 1 had a significantly lower average age) we tested significance and strength of the correlation of those three parameters with functional recovery and quality of life. The results showed that all three parameters significantly correlated with the functional recovery of patients and improving the quality o