Interdisciplinary rehabilitation in elderly patients recovering from hip fractures

Abstract

Background- Hip fracture is a very serious injury which can potentially develop significant complications which are life-threatening. A hip fracture can occur very easily with a higher probability for elderly individuals. There are several causes of hip fracture in elderly, including and not limited to; sudden falling due to poor vision, osteoporosis (bones weakness) and gait imbalance. The research question- In elderly patients recovering from hip fracture, does interdisciplinary rehabilitation lead to improved functional status earlier than usual care? PICO elements- The population (P) included elderly persons over 60 years of age. The intervention (I) refers to the rehabilitation programme by an interdisciplinary approach while the comparison consisted of rehabilitation (C), from a hip fracture elderly without undergoing a structured programme. Finally, the outcome (O) exhibits the functional status of the patient following the kind of care. Moreover, the difference about the length of stay (T) is also going to be observed. Inclusion criteria- Research consisted of searching study reports investigating the effectiveness of a rehabilitation programme with an interdisciplinary team approach for hip fracture elderly with a focus on the functional status. The author ensured that; all selected articles for analysis was published between 2000 and 2015, the studies were available online and in English language, and that the study designs were randomised controlled trials, systematic reviews, meta-analysis or cohort studies. Research was carried out on the following areas: hip fracture, rehabilitation and interdisciplinary approach. Search outcome- Three studies which were selected were closely related to responding the PICO question. Two studies were randomised controlled, whilst the other one was a cohort study. Quality assessment- The Critical Appraisal skill Programme (CASP) tool was used to examine the quality and the reliability of the studies. Results- All three studies concluded that a rehabilitation programme along with an interdisciplinary team, have a positive impact on the rehabilitation hip fractures elderly from many aspects including; functional status, gaining independence, activities of daily living, shorter length of stay and less depression symptoms Implications: The introduction of a structured rehabilitation programme by an interdisciplinary team may be of value in improving outcome for elderly patients, their families, the hospital and Maltese society. Elderly regaining their health will be less dependent on others, vacate beds and return to a productive self-fulfilling life. Recommendations- Comprehensive education to healthcare professionals in this field is needed for ensuring holistic care and evidence based practice. Adequate and refurbishing the hospital with modern equipment is needed to assist the patient and the staff for improved outcome.