Original researchAssociation Between Orthostatic Hypotension and Handgrip Strength With Successful Rehabilitation in Elderly Hip Fracture Patients
Section snippets
Study population
This prospective, observational cohort study was performed in a general hospital (Isala Hospital, Zwolle, The Netherlands). All patients aged ≥70 years who were admitted to the hospital with a hip fracture and treated with surgery were eligible, and most of them were recruited. Some patients could not be recruited because they were admitted during the night.
Recruitment and all study procedures took place between November 2014 and December 2015. Exclusion criteria were having a life expectancy
Results
A total of 116 patients were included in this cohort. The baseline characteristics are presented in table 1. The median age of the total study population was 82 years (IQR, 76–86y). Various surgical techniques were used to treat the hip fractures: 37% intramedullary nail, 50% hemi- or total hip arthroplasty, and 13% (sliding) hip screws. Thirty-nine patients (34%) were discharged to their own homes and 77 patients (66%) to a nursing home facility for further rehabilitation. During a median
Discussion
OH, measured in the immediate postoperative phase, was not related to time to successful rehabilitation in hospitalized elderly with a hip fracture. Although increased muscle strength was not significantly related to time to successful rehabilitation in the present study, the width of the CI does not exclude a relevant relationship between handgrip strength and time to successful rehabilitation. Besides, muscle strength as a confounder, in the model with OH as the variable of interest, was
Conclusions
In conclusion, this study showed that OH measured during the first days of hospitalization was not related to time to successful rehabilitation. Although no significant relationship was seen in the present study, the width of the CI does not exclude a relevant relationship between handgrip strength and time to successful rehabilitation.
Suppliers
- a.
A&D UA-767 Plus; A&D Company.
- b.
Heine Gamma XXL-T sphygmomanometer; Heine Optotechnik.
- c.
Jamar hand dynamometer; Patterson Medical.
- d.
SPSS software (version 22); IBM Corp.
Acknowledgment
We thank K.H. Groenier, PhD, for helping with the statistical analyses.
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Handgrip strength predicts length of stay and quality of life in and out of hospital
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2017, Physical Medicine and Rehabilitation Clinics of North AmericaCitation Excerpt :As with cognitive impairments, the clinician should avoid polypharmacy and incorporate a holistic approach to the rehabilitation plan, focusing on nonpharmacologic interventions with medications serving only as adjuvants to decrease symptom burden. Orthostatic hypotension is common in the elderly.41 It is defined as a decrease of 20 mm Hg in the systolic blood pressure and/or decrease of 10 mm Hg in the diastolic blood pressure within 3 minutes of sitting or standing.42
Supported by the Isala Innovation and Research Fund. The role of the sponsor was solely financial support. The sponsor had no involvement in the study design, in the collection, analysis, and interpretation of data, in the writing of the report, or in the decision to submit the article for publication.
Disclosures: none.