Comparative outcomes of inpatient fragility fracture intensive rehabilitation management (FIRM) after hip fracture in sarcopenic and non-sarcopenic patients: a prospective observational study.

purposeTo evaluate the effects of fragility fracture integrated rehabilitation management (FIRM) on the functional outcomes of sarcopenic and non-sarcopenic inpatients following hip fracture surgery.

methodsThis prospective observational study was carried out with patients over 65 years of age who underwent hip surgery for fragility hip fracture and received multidisciplinary rehabilitation. Sarcopenia was defined according to the Asian Working Group for Sarcopenia criteria. Demographic and functional characteristics were analyzed before and after rehabilitation during inpatient care to evaluate short-term outcomes.

resultsSixty-eight patients were eligible for the study, and 32 (47.1%) satisfied the criteria for sarcopenia. The pre-fracture ambulatory status was lower in the sarcopenia group (KOVAL: 1.74 ± 1.42 vs. 1.22 ± 0.42, p = 0.022). The overall functional levels were significantly lower in the sarcopenia group before and after rehabilitation. Overall function was significantly improved in both groups after FIRM, and with the exception of Korean Instrumental Activities of Daily Living scores, there were no differences between the groups in the changes after FIRM. Pre-fracture independent ambulatory function was significantly correlated with short-term ambulatory functional recovery in both sarcopenia and non-sarcopenia groups [n = 22 (91.7%), p = 0.023 vs. n = 27 (84.4%), p = 0.028].

conclusionsOur results suggest that FIRM was effective for short-term functional recovery in older patients with or without sarcopenia who have suffered fragility hip fracture. Considering sarcopenia, which has a detrimental effect on functional outcomes after rehabilitation, the impact of sarcopenia on FIRM should be investigated further over a longer period of time.