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No rest for the wounded: early ambulation after hip surgery accelerates recovery.
ANZ J Surg. 2006 Jul; 76(7):607-11.AJ

Abstract

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.

Authors+Show Affiliations

Department of Physiotherapy, The Alfred, Melbourne, Australia. l.oldmeadow@alfred.org.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16813627

Citation

Oldmeadow, Leonie B., et al. "No Rest for the Wounded: Early Ambulation After Hip Surgery Accelerates Recovery." ANZ Journal of Surgery, vol. 76, no. 7, 2006, pp. 607-11.
Oldmeadow LB, Edwards ER, Kimmel LA, et al. No rest for the wounded: early ambulation after hip surgery accelerates recovery. ANZ J Surg. 2006;76(7):607-11.
Oldmeadow, L. B., Edwards, E. R., Kimmel, L. A., Kipen, E., Robertson, V. J., & Bailey, M. J. (2006). No rest for the wounded: early ambulation after hip surgery accelerates recovery. ANZ Journal of Surgery, 76(7), 607-11.
Oldmeadow LB, et al. No Rest for the Wounded: Early Ambulation After Hip Surgery Accelerates Recovery. ANZ J Surg. 2006;76(7):607-11. PubMed PMID: 16813627.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - No rest for the wounded: early ambulation after hip surgery accelerates recovery. AU - Oldmeadow,Leonie B, AU - Edwards,Elton R, AU - Kimmel,Lara A, AU - Kipen,Eva, AU - Robertson,Val J, AU - Bailey,Michael J, PY - 2006/7/4/pubmed PY - 2006/9/15/medline PY - 2006/7/4/entrez SP - 607 EP - 11 JF - ANZ journal of surgery JO - ANZ J Surg VL - 76 IS - 7 N2 - 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. SN - 1445-1433 UR - https://www.unboundmedicine.com/medline/citation/16813627/No_rest_for_the_wounded:_early_ambulation_after_hip_surgery_accelerates_recovery_ L2 - https://doi.org/10.1111/j.1445-2197.2006.03786.x DB - PRIME DP - Unbound Medicine ER -