Mobility improvement in the first 6 postoperative weeks in orthogeriatric fracture patients
Background Physical activity is a relevant outcome parameter in orthopedic surgery, that can be objectively assessed. Until now, there is little information regarding objective gait parameters in the orthogeriatric population. This study focuses on the first 6 weeks of postoperative rehabilitation,...
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| Veröffentlicht in: | European journal of trauma and emergency surgery (Munich : 2007) 2022-08, Vol.48 (4), p.2867-2872 |
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| creator | Keppler, Alexander M. Holzschuh, Jenny Pfeufer, Daniel Gleich, Johannes Neuerburg, Carl Kammerlander, Christian Böcker, Wolfgang Fürmetz, Julian |
| description | Background
Physical activity is a relevant outcome parameter in orthopedic surgery, that can be objectively assessed. Until now, there is little information regarding objective gait parameters in the orthogeriatric population. This study focuses on the first 6 weeks of postoperative rehabilitation, and delivers objective data about gait speed and step length in typical orthogeriatric fracture patterns.
Methods
Thirty-one orthogeriatric fracture patients [pertrochanteric femur fractures (PFF), femoral neck (FN), and proximal humerus fractures (PHF)] were consecutively enrolled in a maximum care hospital in a prospective study design. All patients wore an accelerometer placed at the waist during the postoperative stay (24 h/d) and at 6-week follow-up, to measure real gait speed and step length. In addition, self-assessment of mobility (Parker mobility score) and activities of daily living (Barthel index) were collected at baseline, during the inpatient stay, and at 6-week follow-up.
Results
During postoperative hospitalization, significantly higher gait speed (m/s) was observed in the PHF group (0.52 ± 0.27) compared with the FN group (0.36 ± 0.28) and PFF group (0.19 ± 0.28) (
p
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| doi_str_mv | 10.1007/s00068-021-01856-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9360084</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2699828360</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-ac09a4520984ecb5b2a02229675f859f54f5c23b115428c2868917f1627286cf3</originalsourceid><addsrcrecordid>eNp9kU1vFSEUhomxsbX6B1wYEjduxsLhY2BjYpr6kdS40ZULwiD0UmeGEZhr-u_leuutdeGKk_Cc53B4EXpGyStKSH9WCCFSdQRoR6gSsiMP0AlVknVac_rwUDN2jB6Xct1oIgU8QseMawYU-An6-jENcYz1BsdpyWnrJz9XHGdcNx6HmEvFEi-p1LT4bGvcevzT--9lh6RcN-nK52hrjg6HbF1ds8dL45qlPEFHwY7FP709T9GXtxefz993l5_efTh_c9k53vPaWUe05QKIVty7QQxgCQBo2YughA6CB-GADZQKDsqBkkrTPlAJfatdYKfo9d67rMPkv7k2O9vRLDlONt-YZKO5fzPHjblKW6OZJETxJnh5K8jpx-pLNVMszo-jnX1aiwFJgfWKU9XQF_-g12nNc1uvUVorUM3ZKNhTLqdSsg-Hx1BidtmZfXamZWd-Z2d2Tc__XuPQ8iesBrA9UNrV3D7-bvZ_tL8AuymlTw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2699828360</pqid></control><display><type>article</type><title>Mobility improvement in the first 6 postoperative weeks in orthogeriatric fracture patients</title><source>Springer Nature - Complete Springer Journals</source><creator>Keppler, Alexander M. ; Holzschuh, Jenny ; Pfeufer, Daniel ; Gleich, Johannes ; Neuerburg, Carl ; Kammerlander, Christian ; Böcker, Wolfgang ; Fürmetz, Julian</creator><creatorcontrib>Keppler, Alexander M. ; Holzschuh, Jenny ; Pfeufer, Daniel ; Gleich, Johannes ; Neuerburg, Carl ; Kammerlander, Christian ; Böcker, Wolfgang ; Fürmetz, Julian</creatorcontrib><description>Background
Physical activity is a relevant outcome parameter in orthopedic surgery, that can be objectively assessed. Until now, there is little information regarding objective gait parameters in the orthogeriatric population. This study focuses on the first 6 weeks of postoperative rehabilitation, and delivers objective data about gait speed and step length in typical orthogeriatric fracture patterns.
Methods
Thirty-one orthogeriatric fracture patients [pertrochanteric femur fractures (PFF), femoral neck (FN), and proximal humerus fractures (PHF)] were consecutively enrolled in a maximum care hospital in a prospective study design. All patients wore an accelerometer placed at the waist during the postoperative stay (24 h/d) and at 6-week follow-up, to measure real gait speed and step length. In addition, self-assessment of mobility (Parker mobility score) and activities of daily living (Barthel index) were collected at baseline, during the inpatient stay, and at 6-week follow-up.
Results
During postoperative hospitalization, significantly higher gait speed (m/s) was observed in the PHF group (0.52 ± 0.27) compared with the FN group (0.36 ± 0.28) and PFF group (0.19 ± 0.28) (
p
< 0.05). Six weeks postoperatively, gait speed improved significantly in all groups (PHF 0.90 ± 0.41; FN 0.72 ± 0.13; PFF 0.60 ± 0.23). Similarly, step length (m) differed between groups postoperatively [FN 0.16 ± 0.13; PFF 0.12 ± 0.15; PHF 0.31 ± 0.05 (
p
< 0.005)] and improved over time significantly (FN 0.47 ± 0.01; 0.39 ± 0.19; 0.50 ± 0.18). Self-assessment scores indicate that the majority of the patients had minor restrictions in mobility before the fracture. These values decreased immediately postoperatively and improved in the first 6 weeks, but did not reach the initial level.
Conclusions
Gait speed, step length, and self-assessment in terms of mobility and activities of daily living improve significantly in the first 6 postoperative weeks in orthogeriatric fracture patients. As very low postoperative mobility during hospitalization was observed, this collective shows great potential in postoperative rehabilitation regardless of their fracture pattern. For this reason, specific aftercare concepts similar to the “fast track” concepts in primary arthroplasty are crucial for orthogeriatric patients in clinical practice.
Level of evidence
Prospective cohort study, 2.</description><identifier>ISSN: 1863-9933</identifier><identifier>EISSN: 1863-9941</identifier><identifier>DOI: 10.1007/s00068-021-01856-0</identifier><identifier>PMID: 34932124</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Activities of daily living ; Bone surgery ; Critical Care Medicine ; Emergency Medicine ; Fractures ; Gait ; Intensive ; Medicine ; Medicine & Public Health ; Original ; Original Article ; Postoperative period ; Self evaluation ; Sports Medicine ; Surgery ; Surgical Orthopedics ; Traumatic Surgery</subject><ispartof>European journal of trauma and emergency surgery (Munich : 2007), 2022-08, Vol.48 (4), p.2867-2872</ispartof><rights>The Author(s) 2021</rights><rights>2021. The Author(s).</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-ac09a4520984ecb5b2a02229675f859f54f5c23b115428c2868917f1627286cf3</citedby><cites>FETCH-LOGICAL-c474t-ac09a4520984ecb5b2a02229675f859f54f5c23b115428c2868917f1627286cf3</cites><orcidid>0000-0002-1800-5278</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00068-021-01856-0$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00068-021-01856-0$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34932124$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Keppler, Alexander M.</creatorcontrib><creatorcontrib>Holzschuh, Jenny</creatorcontrib><creatorcontrib>Pfeufer, Daniel</creatorcontrib><creatorcontrib>Gleich, Johannes</creatorcontrib><creatorcontrib>Neuerburg, Carl</creatorcontrib><creatorcontrib>Kammerlander, Christian</creatorcontrib><creatorcontrib>Böcker, Wolfgang</creatorcontrib><creatorcontrib>Fürmetz, Julian</creatorcontrib><title>Mobility improvement in the first 6 postoperative weeks in orthogeriatric fracture patients</title><title>European journal of trauma and emergency surgery (Munich : 2007)</title><addtitle>Eur J Trauma Emerg Surg</addtitle><addtitle>Eur J Trauma Emerg Surg</addtitle><description>Background
Physical activity is a relevant outcome parameter in orthopedic surgery, that can be objectively assessed. Until now, there is little information regarding objective gait parameters in the orthogeriatric population. This study focuses on the first 6 weeks of postoperative rehabilitation, and delivers objective data about gait speed and step length in typical orthogeriatric fracture patterns.
Methods
Thirty-one orthogeriatric fracture patients [pertrochanteric femur fractures (PFF), femoral neck (FN), and proximal humerus fractures (PHF)] were consecutively enrolled in a maximum care hospital in a prospective study design. All patients wore an accelerometer placed at the waist during the postoperative stay (24 h/d) and at 6-week follow-up, to measure real gait speed and step length. In addition, self-assessment of mobility (Parker mobility score) and activities of daily living (Barthel index) were collected at baseline, during the inpatient stay, and at 6-week follow-up.
Results
During postoperative hospitalization, significantly higher gait speed (m/s) was observed in the PHF group (0.52 ± 0.27) compared with the FN group (0.36 ± 0.28) and PFF group (0.19 ± 0.28) (
p
< 0.05). Six weeks postoperatively, gait speed improved significantly in all groups (PHF 0.90 ± 0.41; FN 0.72 ± 0.13; PFF 0.60 ± 0.23). Similarly, step length (m) differed between groups postoperatively [FN 0.16 ± 0.13; PFF 0.12 ± 0.15; PHF 0.31 ± 0.05 (
p
< 0.005)] and improved over time significantly (FN 0.47 ± 0.01; 0.39 ± 0.19; 0.50 ± 0.18). Self-assessment scores indicate that the majority of the patients had minor restrictions in mobility before the fracture. These values decreased immediately postoperatively and improved in the first 6 weeks, but did not reach the initial level.
Conclusions
Gait speed, step length, and self-assessment in terms of mobility and activities of daily living improve significantly in the first 6 postoperative weeks in orthogeriatric fracture patients. As very low postoperative mobility during hospitalization was observed, this collective shows great potential in postoperative rehabilitation regardless of their fracture pattern. For this reason, specific aftercare concepts similar to the “fast track” concepts in primary arthroplasty are crucial for orthogeriatric patients in clinical practice.
Level of evidence
Prospective cohort study, 2.</description><subject>Activities of daily living</subject><subject>Bone surgery</subject><subject>Critical Care Medicine</subject><subject>Emergency Medicine</subject><subject>Fractures</subject><subject>Gait</subject><subject>Intensive</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original</subject><subject>Original Article</subject><subject>Postoperative period</subject><subject>Self evaluation</subject><subject>Sports Medicine</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Traumatic Surgery</subject><issn>1863-9933</issn><issn>1863-9941</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kU1vFSEUhomxsbX6B1wYEjduxsLhY2BjYpr6kdS40ZULwiD0UmeGEZhr-u_leuutdeGKk_Cc53B4EXpGyStKSH9WCCFSdQRoR6gSsiMP0AlVknVac_rwUDN2jB6Xct1oIgU8QseMawYU-An6-jENcYz1BsdpyWnrJz9XHGdcNx6HmEvFEi-p1LT4bGvcevzT--9lh6RcN-nK52hrjg6HbF1ds8dL45qlPEFHwY7FP709T9GXtxefz993l5_efTh_c9k53vPaWUe05QKIVty7QQxgCQBo2YughA6CB-GADZQKDsqBkkrTPlAJfatdYKfo9d67rMPkv7k2O9vRLDlONt-YZKO5fzPHjblKW6OZJETxJnh5K8jpx-pLNVMszo-jnX1aiwFJgfWKU9XQF_-g12nNc1uvUVorUM3ZKNhTLqdSsg-Hx1BidtmZfXamZWd-Z2d2Tc__XuPQ8iesBrA9UNrV3D7-bvZ_tL8AuymlTw</recordid><startdate>20220801</startdate><enddate>20220801</enddate><creator>Keppler, Alexander M.</creator><creator>Holzschuh, Jenny</creator><creator>Pfeufer, Daniel</creator><creator>Gleich, Johannes</creator><creator>Neuerburg, Carl</creator><creator>Kammerlander, Christian</creator><creator>Böcker, Wolfgang</creator><creator>Fürmetz, Julian</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1800-5278</orcidid></search><sort><creationdate>20220801</creationdate><title>Mobility improvement in the first 6 postoperative weeks in orthogeriatric fracture patients</title><author>Keppler, Alexander M. ; Holzschuh, Jenny ; Pfeufer, Daniel ; Gleich, Johannes ; Neuerburg, Carl ; Kammerlander, Christian ; Böcker, Wolfgang ; Fürmetz, Julian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-ac09a4520984ecb5b2a02229675f859f54f5c23b115428c2868917f1627286cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Activities of daily living</topic><topic>Bone surgery</topic><topic>Critical Care Medicine</topic><topic>Emergency Medicine</topic><topic>Fractures</topic><topic>Gait</topic><topic>Intensive</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original</topic><topic>Original Article</topic><topic>Postoperative period</topic><topic>Self evaluation</topic><topic>Sports Medicine</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Traumatic Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Keppler, Alexander M.</creatorcontrib><creatorcontrib>Holzschuh, Jenny</creatorcontrib><creatorcontrib>Pfeufer, Daniel</creatorcontrib><creatorcontrib>Gleich, Johannes</creatorcontrib><creatorcontrib>Neuerburg, Carl</creatorcontrib><creatorcontrib>Kammerlander, Christian</creatorcontrib><creatorcontrib>Böcker, Wolfgang</creatorcontrib><creatorcontrib>Fürmetz, Julian</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of trauma and emergency surgery (Munich : 2007)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Keppler, Alexander M.</au><au>Holzschuh, Jenny</au><au>Pfeufer, Daniel</au><au>Gleich, Johannes</au><au>Neuerburg, Carl</au><au>Kammerlander, Christian</au><au>Böcker, Wolfgang</au><au>Fürmetz, Julian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mobility improvement in the first 6 postoperative weeks in orthogeriatric fracture patients</atitle><jtitle>European journal of trauma and emergency surgery (Munich : 2007)</jtitle><stitle>Eur J Trauma Emerg Surg</stitle><addtitle>Eur J Trauma Emerg Surg</addtitle><date>2022-08-01</date><risdate>2022</risdate><volume>48</volume><issue>4</issue><spage>2867</spage><epage>2872</epage><pages>2867-2872</pages><issn>1863-9933</issn><eissn>1863-9941</eissn><abstract>Background
Physical activity is a relevant outcome parameter in orthopedic surgery, that can be objectively assessed. Until now, there is little information regarding objective gait parameters in the orthogeriatric population. This study focuses on the first 6 weeks of postoperative rehabilitation, and delivers objective data about gait speed and step length in typical orthogeriatric fracture patterns.
Methods
Thirty-one orthogeriatric fracture patients [pertrochanteric femur fractures (PFF), femoral neck (FN), and proximal humerus fractures (PHF)] were consecutively enrolled in a maximum care hospital in a prospective study design. All patients wore an accelerometer placed at the waist during the postoperative stay (24 h/d) and at 6-week follow-up, to measure real gait speed and step length. In addition, self-assessment of mobility (Parker mobility score) and activities of daily living (Barthel index) were collected at baseline, during the inpatient stay, and at 6-week follow-up.
Results
During postoperative hospitalization, significantly higher gait speed (m/s) was observed in the PHF group (0.52 ± 0.27) compared with the FN group (0.36 ± 0.28) and PFF group (0.19 ± 0.28) (
p
< 0.05). Six weeks postoperatively, gait speed improved significantly in all groups (PHF 0.90 ± 0.41; FN 0.72 ± 0.13; PFF 0.60 ± 0.23). Similarly, step length (m) differed between groups postoperatively [FN 0.16 ± 0.13; PFF 0.12 ± 0.15; PHF 0.31 ± 0.05 (
p
< 0.005)] and improved over time significantly (FN 0.47 ± 0.01; 0.39 ± 0.19; 0.50 ± 0.18). Self-assessment scores indicate that the majority of the patients had minor restrictions in mobility before the fracture. These values decreased immediately postoperatively and improved in the first 6 weeks, but did not reach the initial level.
Conclusions
Gait speed, step length, and self-assessment in terms of mobility and activities of daily living improve significantly in the first 6 postoperative weeks in orthogeriatric fracture patients. As very low postoperative mobility during hospitalization was observed, this collective shows great potential in postoperative rehabilitation regardless of their fracture pattern. For this reason, specific aftercare concepts similar to the “fast track” concepts in primary arthroplasty are crucial for orthogeriatric patients in clinical practice.
Level of evidence
Prospective cohort study, 2.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34932124</pmid><doi>10.1007/s00068-021-01856-0</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-1800-5278</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1863-9933 |
| ispartof | European journal of trauma and emergency surgery (Munich : 2007), 2022-08, Vol.48 (4), p.2867-2872 |
| issn | 1863-9933 1863-9941 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9360084 |
| source | Springer Nature - Complete Springer Journals |
| subjects | Activities of daily living Bone surgery Critical Care Medicine Emergency Medicine Fractures Gait Intensive Medicine Medicine & Public Health Original Original Article Postoperative period Self evaluation Sports Medicine Surgery Surgical Orthopedics Traumatic Surgery |
| title | Mobility improvement in the first 6 postoperative weeks in orthogeriatric fracture patients |
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