Weekend holiday rehabilitation supports recovery in elderly hip fracture patients

Hip fractures are common in the elderly, with many patients experiencing a decline in Activities of Daily Living (ADL) post-surgery. Therefore, postoperative rehabilitation plays a crucial role in helping patients recover to their pre-injury ADL level. Previous studies have shown that providing rehabilitation on weekdays and outside of normal business hours, such as on the weekend and public holidays, during hospitalization promotes improvements in ADL. However, many medical institutions have limited human resources, making it difficult to provide rehabilitation services to all patients on holidays. Consequently, decisions on which patients should receive priority intervention are currently made based on medical professionals' discretion.

To devise a better course of action, a Graduate School of Medicine research group, led by the student Tsubasa Bito, Specially Appointed Assistant Professor Ryota Kawai, and Professor Ayumi Shintani from the Department of Medical Statistics and the Department of Orthopedic Surgery's Dr. Shinji Takahashi, analyzed 77,947 patients aged 60 or older who underwent surgery after a hip fracture. Using the Barthel Index, which assesses ADL from 0 (complete dependence) to 100 (complete independence), the research team analyzed the impact on ADL at discharge when rehabilitation was provided within 7 days after surgery, including on holidays. The team made comparisons according to differences in age and ADL status at admission.

Their findings revealed that patients over 80 and those with initial Barthel Index scores of 0−10 who received rehabilitation on holidays had higher ADL scores at discharge. In contrast, those admitted with higher Barthel Index scores did not show significant improvement in ADL scores after additional holiday rehabilitation by the time they were discharged.

"The results of this study provide large-scale data supporting the practice of prioritizing interventions for elderly patients and those with difficulty performing activities independently, which had previously been based on empirical experience," stated Bito.

We believe the research findings will provide useful information for prescribing effective rehabilitation with limited human resources."

Professor Ayumi Shintani, Department of Medical Statistics, Osaka Metropolitan University

The findings were published in Annals of Physical and Rehabilitation Medicine.