Quality of life after hip operation and rehabilitation in elderly patients

Cilj: Utvrditi funkcionalni i mentalni status pacijenata pre i posle medicinske rehabilitacije, a nakon operacije kuka kod osoba starije životne dobi primenom standardizovanih upitnika (SF36, Harris hip score, MMS, TUG, FES-I) . Materijal i metod:Istraživanje je bilo prospektivno i uzorak je činilo 96 pacijenata sa prethodnom operacijom kuka koji su u toku 18 meseci, od januara 2014., bili u rehabilitacionom programu na Klinici za medicinsku rehabilitaciju KCV. Kod svih pacijenata je registrovan: pol i starosna dob, kao i uzrok odnosno vrsta operativnog zahvata. Pacijenti su pregledani i anketirani sa svih 5 upitnika u tri vremenska trenutka: pre samog početka rehabilitacionog tretmana i na 3 i 6 meseci posle. SF-36 je generički merni obrazac koji se koristi za procenu kvaliteta života. Harris Hip Score (HHS) predstavlja merni instrument za procenu funkcionalnih parametara. Mini Mental State (MMS) se koristi kod procene mentalnog statusa. Timed Up and Go Test (TUG) je efikasan metod procene pokretljivosti i funkcije lokomotornog sistema kod starijih pacijenata. Falls Efficacy Scale- International (FES-I) je test kojim se meri stepen zabrinutosti od pada. Metodom ponovljenih merenja analizirana su stanja pacijenata pre i posle medicinske rehabilitacije. Izvršena je i korelaciona analiza korišćenih upitnika, kao i univarijantna analiza u odnosu na vrstu operacije. Rezultati:Nakon medicinske rehabilitacije posle operacije kuka kod osoba starije životne dobi je značajno bolji ukupni fizički skor SF36: 29,0 / 38,7 / 46,3; kao i vrednost HHS skora 50,2 / 63,4 / 76,3; i TUG testa 31,3s / 19,6s / 13,6s; (pre rehabilitacije, 3m i 6m respektivno). Postoje statistički značajne korelacije ukupnog fizičkog domena SF36 i vrednosti Harris Hip, TUG i FES-I, kao i ukupnog mentalnog domena SF36 i MMS skora. Zadovoljstvo pacijenata rehablitacionim tretmanom je u korelaciji sa vrednostima funkcionalnih testova (Harris Hip Score), testom ustani kreni (TUG) i ukupnim fizičkim domenom upitnika SF36, kao i sa skorom FES-I. Zaključci: Kvalitet života i funkcionalna sposobnost operisanih pacijenata nakon medicinske rehabilitacije je značajno bolja kako u komparaciji stanja na tri meseca i na početku rehabilitacije tako i u komparaciji stanja na 6 meseci u odnosu na stanje na 3 meseca.Objective: To determine the functional and mental status of patients before and after medical rehabilitation after hip surgery in elderly by using standardized questionnaires (SF36, Harris hip score, MMS, TUG, FES-I). Materials and methods:The study was prospective and the sample consisted of 96 patients with previous hip surgery that during the 18 months from January 2014, was in a rehabilitation program at the Department of medical rehabilitation KCV. For all patients registered sex and age, as well as the cause and type of surgery.Patients are screened and interviewed with all 5 of the questionnaire in three time points: before the start of the rehabilitation treatment and at 3 and 6 months after. SF-36 is a generic form that measurement is used to assess the quality of life. Harris Hip Score (HHS) is a measuring instrument for the assessment of functional parameters. Mini Mental State (MMS) used in the assessment of mental status. Timed Up and Go Test (TUG) is an effective method of evaluating the mobility and function of the musculoskeletal system in older patients.Falls Efficacy Scale- International (FES-I) is a test that measures the level of concern of falling. Method of repeated measurements were used to analyse condition of patients before and after medical rehabilitation. There was also a correlation analysis of used questionnaires, as well as the univariate analysis in relation to the type of surgery. Results: After medical rehabilitation after surgery of the hip in the elderly is significantly better overall physical SF36 score: 29.0 / 38.7 / 46.3; as well as the value of the HHS score of 50.2 / 63.4 / 76.3; and the TUG test 31,3s / 19,6s / 13,6s; (before rehabilitation, 3m and 6m respectively). There are statistically significant correlations of total physical domain SF36 and values Harris Hip, TUG and the FES-I, and the overall mental domain of SF36 and MMS score. Patient satisfaction with rehabilitation treatment is correlated with the values of functional tests (Harris Hip Score) test Up and go (TUG) and total physical domain SF36 questionnaires, as well as the FES-I. Conclusion: Quality of life and functional capacity of treated patients after medical rehabilitation significantly improved both in comparison to the situation in three months and at the beginning of rehabilitation as well as in comparison at 6 months compared to 3 months