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ABSTRACT: Objectives
This study aimed to describe gait speed at admission and discharge from inpatient hospital rehabilitation among older adults recovering from orthopaedic trauma and factors associated with gait speed performance and discharge destination.Design
A longitudinal cohort study was conducted.Setting
Australian tertiary hospital subacute rehabilitation wards.Participants
Patients aged ?60 years recovering from orthopaedic trauma (n=746, 71% female) were eligible for inclusion.Interventions
Usual care (multidisciplinary inpatient hospital rehabilitation).Primary and secondary outcome measures
Gait speed was assessed using the timed 10 m walk test. The proportion of patients exceeding a minimum gait speed threshold indicator (a priori 0.8 m/s) of community ambulation ability was calculated. Generalised linear models were used to examine associations between patient and clinical factors with gait speed performance and being discharged to a residential aged care facility.Results
At discharge, 18% of patients (n=135) exceeded the 0.8 m/s threshold indicator for community ambulation ability. Faster gait speed at discharge was found to be associated with being male (B=0.43, 95%?CI -0.01 to 0.87), admitted with pelvic (B=0.76, 95%?CI 0.14 to 1.37) or multiple fractures (B=1.13, 95%?CI 0.25 to 2.01) (vs hip fracture), using no mobility aids (B=-0.93, 95%?CI -1.89 to 0.01) and walking at a faster gait speed at admission (B=5.77, 95%?CI 5.03 to 6.50). Factors associated with being discharged to residential aged care included older age (OR 1.06, 95%?CI 1.03 to 1.10), longer length of stay (OR 1.01, 95%?CI 1.01 to 1.02), having an upper limb fracture (vs hip fracture) (OR 2.81, 95%?CI 1.32 to 5.97) and lower Functional Independence Measure cognitive score (OR 0.89, 95%?CI 0.86 to 0.92).Conclusions
Patients with a range of injury types, not only those presenting to hospital with hip fractures, are being discharged with slow gait speeds that are indicative of limited functional mobility and a high risk of further adverse health events.
SUBMITTER: Mathew SA
PROVIDER: S-EPMC5541473 | biostudies-literature | 2017 Jul
REPOSITORIES: biostudies-literature
Mathew Saira A SA Varghese Paul P Kuys Suzanne S SS Heesch Kristiann C KC McPhail Steven M SM
BMJ open 20170720 7
<h4>Objectives</h4>This study aimed to describe gait speed at admission and discharge from inpatient hospital rehabilitation among older adults recovering from orthopaedic trauma and factors associated with gait speed performance and discharge destination.<h4>Design</h4>A longitudinal cohort study was conducted.<h4>Setting</h4>Australian tertiary hospital subacute rehabilitation wards.<h4>Participants</h4>Patients aged ≥60 years recovering from orthopaedic trauma (n=746, 71% female) were eligibl ...[more]