A hip fracture is one of the most common injuries in older adults, with about 90% of fractures occurring in people over 60. Hip fractures usually require surgery (and possibly hip replacement) followed by intensive rehabilitation. It is critical that rehabilitation services begin early and continue until the patient reaches his or her maximal functional level.
Virtually anyone will benefit from some type of physical rehabilitation after hip fracture: The primary goals are to reduce disability and maximize function so that the patient can return to his or her prior activity level. Specific goals are determined based on the patient’s status before the fracture, living environment, and input from both patient and family.
Physical therapy after hip fracture involves assessing the patient's ability to:
- Get in and out of bed unassisted
- Transfer from bed to a chair
- Walk a limited distance
- Go up and down stairs
The physical therapist will prescribe exercises to help the patient reach these goals. The patient typically will need an assistive device (a walker, for example) for a period of time, and the therapist will assess that as well to ensure that it is fitted appropriately.
Occupational therapy after hip fracture focuses on the patient's ability to:
- Use the toilet
The occupational therapist will also work with the patient so that the patient can accomplish other everyday activities like managing in the kitchen. The therapist will also recommend adaptive devices if needed.
Speech therapy is sometimes needed following a hip fracture due to unexpected:
- Changes in ability to swallow: A speech-language pathologist can determine the cause of the swallowing changes and make recommendations to avoid a decline in the patient's nutrition and hydration, as well as help prevent pneumonia.
- Decline in attention, memory or other thinking skills: After any changes are assessed, therapy can be targeted to support the patient's return to maximum independence and enjoyment of activities that are important to the patient.
Where rehabilitation takes place and the type of services prescribed depend on the patient. Patient age, status after surgery and presence of other medical conditions all need to be considered. Assessing these issues, among others will help determine if the patient is admitted to a skilled nursing facility or acute rehabilitation facility after hospital discharge, or receives rehabilitation services at home.
The patient may experience strength and balance deficits for several months after the injury; for that reason, continued therapy on an outpatient basis is strongly recommended to achieve the best outcome and avoid further incidents.
Have you rehabbed a fracture or helping a loved one recover from theirs? Share your experiences with us by commenting below.
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