Premium
NO REST FOR THE WOUNDED: EARLY AMBULATION AFTER HIP SURGERY ACCELERATES RECOVERY
Author(s) -
Oldmeadow Leonie B.,
Edwards Elton R,
Kimmel Lara A,
Kipen Eva,
Robertson Val J.,
Bailey Michael J
Publication year - 2006
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2006.03786.x
Subject(s) - medicine , hip fracture , randomization , randomized controlled trial , surgery , prospective cohort study , physical therapy , osteoporosis
Background: Level 3 evidence‐based guidelines recommend first walk after hip fracture surgery within 48 h. Early mobilization is resource and effort intensive and needs rigorous investigation to justify implementation. This study uses a prospective randomized method to investigate the effect of early ambulation (EA) after hip fracture surgery on patient and hospital outcomes. Methods: Sixty patients (41 women and 19 men; mean age 79.4 years) admitted between March 2004 through December 2004 to The Alfred Hospital, Melbourne, for surgical management of a hip fracture were studied. Randomization was either EA (first walk postoperative day 1 or 2) or delayed ambulation (DA) (first walk postoperative day 3 or 4). Functional levels on day 7 post‐surgery, acute hospital length of stay and destination at discharge were compared. Results: At 1 week post‐surgery, patients in the EA group walked further than those in the DA group ( P = 0.03) and required less assistance to transfer ( P = 0.009) and negotiate a step ( P = 0.23). Patients in the EA group were more likely to be discharged directly home from the acute care than those in the DA group (26.3 compared with 2.4%) and less likely to need high‐level care (36.8 compared with 56%). A failed early ambulation subgroup had significantly more postoperative cardiovascular instability and worse results for all outcome measures. Conclusion: EA after hip fracture surgery accelerates functional recovery and is associated with more discharges directly home and less to high‐level care.