Abstract
Background
The functional independence measure (FIM) is an evaluation method of activities of daily living (ADL) that assesses motor functions and cognitive functions in the Uniform Data System. The FIM has recently been used to assess disability. The purpose of this study was to standardize criteria using the FIM for determining when and to where patients can be discharged following surgery for hip fracture.
Methods
Patients with hip fracture (n = 68) aged ≥65 years who underwent surgery at our hospital were classified by their residence at the time of injury (their own home, a hospital, or an elderly care facility) and by postoperative residence after discharge from hospital. We investigated the FIM of these patients before injury and at the time of discharge and retrospectively compared the results with the Japan Orthopaedic Association (JOA) hip score at the time of discharge.
Results
Patients who entered a facility after discharge following surgery demonstrated a reduction in motor function score on the FIM. Cognitive function scores in each group were not reduced postoperatively in the short term. The average reduction in scores on the FIM for patients who were discharged from hospital to their own home was 15.9 points, and it was 25.9 points for those who were injured in their own home and transferred to a facility after discharge. There was a significant correlation between the FIM and the JOA hip score at the time of discharge.
Conclusions
The FIM cannot determine whether such patients should be discharged to their home or transferred to a care facility. However, the motor function scores on the FIM are valid for assessing hip fracture patients and may be suitable as a standardized procedure for determining their postdischarge residence.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
T Iga Y Dohmae N Endo HE Takahashi (1999) ArticleTitleIncrease in the incidence of cervical and trochanteric fractures of the proximal femur in Niigata prefecture Japan J Bone Miner Metab 17 224–31 10.1007/s007740050089 Occurrence Handle10.1007/s007740050089 Occurrence Handle1:STN:280:DC%2BD3c3hvVKgsQ%3D%3D Occurrence Handle10757684
S Kitamura Y Hasegawa S Suzuki R Sasaki H Iwata H Wingstrand et al. (1998) ArticleTitleFunctional outcome after hip fracture in Japan Clin Orthop 348 29–36 Occurrence Handle9553530
M Cree KC Carriere CL Soskolne M Suarez-Almazor (2001) ArticleTitleFunctional dependence after hip fracture Am J Phys Med Rehabil 80 736–43 10.1097/00002060-200110000-00006 Occurrence Handle10.1097/00002060-200110000-00006 Occurrence Handle1:STN:280:DC%2BD3MrhsVGhsA%3D%3D Occurrence Handle11562555
RG Duke JL Keating (2002) ArticleTitleAn investigation of factors predictive of independence in transfers and ambulation after hip fracture Arch Phys Med Rehabil 83 158–64 10.1053/apmr.2002.27463 Occurrence Handle10.1053/apmr.2002.27463 Occurrence Handle11833017
JF Fitzgerald PS Moore RS Dittus (1988) ArticleTitleThe care of elderly patients with hip fracture: changes since implementation of the prospective payment system N Engl J Med 319 1392–7 Occurrence Handle1:STN:280:DyaL1M%2FktVSqsQ%3D%3D Occurrence Handle3185650 Occurrence Handle10.1056/NEJM198811243192106
JS Keene CA Anderson (1982) ArticleTitleHip fractures in the elderly: discharge predictions with a functional rating scale JAMA 248 564–7 10.1001/jama.248.5.564 Occurrence Handle10.1001/jama.248.5.564 Occurrence Handle1:STN:280:DyaL383kt1Cjuw%3D%3D Occurrence Handle7097900
KJ Koval ML Skovron D Polatsch GB Aharonoff JD Zuckerman (1996) ArticleTitleDependency after hip fracture in geriatric patients: a study of predictive factors J Orthop Trauma 10 531–5 10.1097/00005131-199611000-00004 Occurrence Handle10.1097/00005131-199611000-00004 Occurrence Handle1:STN:280:DyaK2s%2FntlWltA%3D%3D Occurrence Handle8915914
ER Marcantonio JM Flacker M Michaels NM Resnick (2000) ArticleTitleDelirium is independently associated with poor functional recovery after hip fracture J Am Geriatr Soc 48 618–24 Occurrence Handle1:STN:280:DC%2BD3czht1artA%3D%3D Occurrence Handle10855596
O Svensson L Strömberg G Öhlén U Lindgren (1996) ArticleTitlePrediction of the outcome after hip fracture in elderly patients J Bone Joint Surg Br 78 115–18 Occurrence Handle1:STN:280:DyaK2s%2FltlOhtA%3D%3D Occurrence Handle8898140
CV Granger AC Cotter BB Hamilton RC Fiedler (1993) ArticleTitleFunctional assessment scales: a study of persons after stroke Arch Phys Med Rehabil 74 133–8 Occurrence Handle1:STN:280:DyaK3s7lvFejsA%3D%3D Occurrence Handle8431095
KJ Ottenbacher Y Hsu CV Granger RC Fiedler (1996) ArticleTitleThe reliability of the functional independence measure: a quantitative review Arch Phys Med Rehabil 77 1226–32 10.1016/S0003-9993(96)90184-7 Occurrence Handle10.1016/S0003-9993(96)90184-7 Occurrence Handle1:STN:280:DyaK2s7jtVGnsg%3D%3D Occurrence Handle8976303
L Tesio CV Granger L Perucca FP Franchignoni MA Battaglia CF Russell (2002) ArticleTitleThe FIM™ instrument in the United States and Italy: a comparative study Am J Phys Med Rehabil 81 168–76 10.1097/00002060-200203000-00003 Occurrence Handle10.1097/00002060-200203000-00003 Occurrence Handle11989512
CV Granger BB Hamilton RA Keith M Zielezny FS Sherwin (1986) ArticleTitleAdvances in functional assessment for medical rehabilitation Top Geriatr Rehabil 1 59–74
RJ Petrella T Overend B Chesworth (2002) ArticleTitleFIM™ after hip fracture: is telephone administration valid and sensitive to change? Am J Phys Med Rehabil 81 639–44 10.1097/00002060-200209000-00001 Occurrence Handle10.1097/00002060-200209000-00001 Occurrence Handle1:STN:280:DC%2BD38vhslCqsA%3D%3D Occurrence Handle12172514
MF Folstein SE Folstein PR McHugh (1975) ArticleTitle“Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician J Psychiatr Res 12 189–98 10.1016/0022-3956(75)90026-6 Occurrence Handle10.1016/0022-3956(75)90026-6 Occurrence Handle1:STN:280:DyaE28%2FntFKjtw%3D%3D Occurrence Handle1202204
S Imura (1995) ArticleTitleEvaluation chart of hip joint functions J Jpn Orthop Assoc 69 860–7
FI Mahoney DW Barthel (1965) ArticleTitleFunctional evaluation: the Barthel Index — a simple index of independence useful in scoring improvement in the rehabilitation of the chronically ill Md State Med J 14 61–5 Occurrence Handle1:STN:280:DyaF2M%2FmtlCltA%3D%3D Occurrence Handle14258950
N Chino TP Anderson CV Granger (1988) ArticleTitleStroke rehabilitation outcome studies; comparison of a Japanese facility with 17 U.S. facilities Int Disabil Stud 10 150–4 Occurrence Handle1:STN:280:DyaL1M7nsVehtA%3D%3D Occurrence Handle3235385
G Yavuzer A Küçükdeveci T Arasil A Elhan (2001) ArticleTitleRehabilitation of stroke patients: clinical profile and functional outcome Am J Phys Med Rehabil 80 250–5 10.1097/00002060-200104000-00003 Occurrence Handle10.1097/00002060-200104000-00003 Occurrence Handle1:STN:280:DC%2BD3M7os1ensA%3D%3D Occurrence Handle11277130
Author information
Authors and Affiliations
About this article
Cite this article
Takeda, H., Kamogawa, J., Sakayama, K. et al. Evaluation of clinical prognosis and activities of daily living using functional independence measure in patients with hip fractures. J Orthop Sci 11, 584–591 (2006). https://doi.org/10.1007/s00776-006-1073-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00776-006-1073-2