Functional Ability, Psychological Factors, and Rehabilitation Outcomes After Elective Total Hip Replacement

Overview

Journal Can J Occup Ther

Specialties Occupational Medicine
Rehabilitation Medicine

Date 2023 Apr 19

PMID 37072927

Authors

Orit Segev-Jacubovski

Affiliations

Soon will be listed here.

Abstract

The role of positive psychological factors in acute rehabilitation after total hip replacement (THR) is unclear. (a) Examine the trajectory of functional ability among older adults after THR from presurgery to discharge from acute rehabilitation and (b) determine which physical and psychological factors at admission would predict functional ability at discharge and length of stay in rehabilitation. This prospective cohort study included 30 participants (age M = 76.20 years) from an inpatient geriatric rehabilitation center. They completed the Geriatric Depression Scale and Positive Affect questionnaire. The FIM® Motor domain of Functional Independent Measure (mFIM) was recorded presurgery, at admission, and upon discharge. Functional ability improved at discharge; however, the presurgery functional ability was not regained. Positive affect explained the length of stay in rehabilitation above and beyond the presurgery mFIM. Occupational therapists should improve ways to enhance self-care and positive affect in acute rehabilitation.

References

Dodds T, Martin D, Stolov W, Deyo R . A validation of the functional independence measurement and its performance among rehabilitation inpatients. Arch Phys Med Rehabil. 1993; 74(5):531-6. DOI: 10.1016/0003-9993(93)90119-u. View

Seale G, Berges I, Ottenbacher K, Ostir G . Change in positive emotion and recovery of functional status following stroke. Rehabil Psychol. 2010; 55(1):33-39. PMC: 3121178. DOI: 10.1037/a0018744. View

Rasch A, Bystrom A, Dalen N, Martinez-Carranza N, Berg H . Persisting muscle atrophy two years after replacement of the hip. J Bone Joint Surg Br. 2009; 91(5):583-8. DOI: 10.1302/0301-620X.91B5.21477. View

Brembo E, Kapstad H, van Dulmen S, Eide H . Role of self-efficacy and social support in short-term recovery after total hip replacement: a prospective cohort study. Health Qual Life Outcomes. 2017; 15(1):68. PMC: 5387328. DOI: 10.1186/s12955-017-0649-1. View

Judd D, Dennis D, Thomas A, Wolfe P, Dayton M, Stevens-Lapsley J . Muscle strength and functional recovery during the first year after THA. Clin Orthop Relat Res. 2013; 472(2):654-64. PMC: 3890211. DOI: 10.1007/s11999-013-3136-y. View

Segev-Jacubovski O, Magen H, Maeir A . Psychological Factors Predicting Functional Ability and Participation After Hip Fracture. Am J Occup Ther. 2022; 76(3). DOI: 10.5014/ajot.2022.047365. View

Ramanathan-Elion D, McWhorter J, Wegener S, Bechtold K . The role of psychological facilitators and barriers to therapeutic engagement in acute, inpatient rehabilitation. Rehabil Psychol. 2016; 61(3):277-287. DOI: 10.1037/rep0000095. View

ONeill T, McCabe P, McBeth J . Update on the epidemiology, risk factors and disease outcomes of osteoarthritis. Best Pract Res Clin Rheumatol. 2018; 32(2):312-326. DOI: 10.1016/j.berh.2018.10.007. View

Hernandez S, Overholser J . A Systematic Review of Interventions for Hope/Hopelessness in Older Adults. Clin Gerontol. 2020; 44(2):97-111. DOI: 10.1080/07317115.2019.1711281. View

10.

Fredrickson B . The broaden-and-build theory of positive emotions. Philos Trans R Soc Lond B Biol Sci. 2004; 359(1449):1367-78. PMC: 1693418. DOI: 10.1098/rstb.2004.1512. View

11.

Taekema D, Gussekloo J, Maier A, Westendorp R, de Craen A . Handgrip strength as a predictor of functional, psychological and social health. A prospective population-based study among the oldest old. Age Ageing. 2010; 39(3):331-7. DOI: 10.1093/ageing/afq022. View

12.

Harris W . Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969; 51(4):737-55. View

13.

Fredman L, Hawkes W, Black S, Bertrand R, Magaziner J . Elderly patients with hip fracture with positive affect have better functional recovery over 2 years. J Am Geriatr Soc. 2006; 54(7):1074-81. DOI: 10.1111/j.1532-5415.2006.00786.x. View

14.

Gunther K, Deckert S, Lutzner C, Lange T, Schmitt J, Postler A . Total Hip Replacement for Osteoarthritis-Evidence-Based and Patient-Oriented Indications. Dtsch Arztebl Int. 2021; 118(43):730-736. PMC: 8820083. DOI: 10.3238/arztebl.m2021.0323. View

15.

Folstein M, Folstein S, McHugh P . "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3):189-98. DOI: 10.1016/0022-3956(75)90026-6. View

16.

Johansson Stark A, Charalambous A, Istomina N, Salantera S, Sigurdardottir A, Sourtzi P . The quality of recovery on discharge from hospital, a comparison between patients undergoing hip and knee replacement - a European study. J Clin Nurs. 2016; 25(17-18):2489-501. DOI: 10.1111/jocn.13278. View

17.

Trudelle-Jackson E, Emerson R, Smith S . Outcomes of total hip arthroplasty: a study of patients one year postsurgery. J Orthop Sports Phys Ther. 2002; 32(6):260-7. DOI: 10.2519/jospt.2002.32.6.260. View

18.

Duivenvoorden T, Vissers M, Verhaar J, Busschbach J, Gosens T, Bloem R . Anxiety and depressive symptoms before and after total hip and knee arthroplasty: a prospective multicentre study. Osteoarthritis Cartilage. 2013; 21(12):1834-40. DOI: 10.1016/j.joca.2013.08.022. View

19.

Kortte K, Stevenson J, Hosey M, Castillo R, Wegener S . Hope predicts positive functional role outcomes in acute rehabilitation populations. Rehabil Psychol. 2012; 57(3):248-255. DOI: 10.1037/a0029004. View

20.

Winther S, Foss O, Klaksvik J, Husby V . Increased Muscle Strength Limits Postural Sway During Daily Living Activities in Total Hip Arthroplasty Patients. Am J Phys Med Rehabil. 2020; 99(7):608-612. PMC: 7292493. DOI: 10.1097/PHM.0000000000001382. View