The association between Orthostatic Hypotension and Handgrip Strength with Successful Rehabilitation in elderly hip fracture patients

Publication date: Available online 16 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): L.C. Hartog, A.M. Winters, H. Roijen, A.M. Kamper, H. Inia, N. Kleefstra, H.J.G. Bilo, K.J.J. van Hateren
ObjectiveOur objectives were to investigate the relationship between orthostatic hypotension (OH) and muscle strength versus time to successful rehabilitation within elderly hip fracture patients.DesignA prospective observational cohort study. Handgrip strength was measured at the day of admission and OH as soon as possible after surgery. Cox proportional hazard modelling was used to investigate the relationship between OH, or handgrip strength (kg) and time to successful rehabilitation, expressed as hazard ratios (HR). OH was defined as a drop in systolic blood pressure of > 20 mmHg or diastolic blood pressure of > 10 mmHg after postural change (dichotomous). Handgrip strength was measured with a hand dynamometer (continuous). The study was registered on trialregister.nl (NTR4940).SettingGeneral hospitalParticipantsPatients of > 70 years with a hip fracture were recruited at the day of hospital admission. A total of 116 patients was included.InterventionsNot applicableMain outcome measuresPrimary outcome was time to successful rehabilitation, which was defined as discharge to patients' own homes.ResultsDuring a median follow-up period of 36 days (IQR 9-57), 103 (89%) patients were successfully rehabilitated. No statistically significant relationships were found between OH and time to successful rehabilitation; HR 1.05 (95% confidence interval (CI) 0.67-1.66)). Also handgrip strength and successful rehabilitation were not statistically significantly related; HR 1.03 (95%CI 0.99-1.06).ConclusionsOH measured during the first days of hospitalization is not related to time to successful rehabilitation in operated hip fracture patients. Although no significant relationship was seen in the present study, the width of the confidence intervals does not exclude a relevant relationship between handgrip strength and time to successful rehabilitation



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