关键词:

远程康复, 移动医疗, 髋部骨折, 老年患者, 社区康复

Abstract:

Objective　To investigate whether a telemedicine solution (using an APP on a pad or a smartphone) can help elderly patients with hip fractures taking functional recovery at home after hospital discharge and meet the needs of individual learning and self-care. Methods　A prospective study was conducted on 100 patients with intertrochanteric fracture of femur who received traumatic orthopedic treatment in Tengzhou Central People's Hospital from January to December 2021. According to the random number method, the patients were divided into an observation group and a control group, with 50 cases in each group. There were 13 males and 37 females in the observation group; they are (82.00±10.68) years old. There were 19 males and 31 females in the control group; they were (81.24±8.29) years old. The observation group used the mobile medical APP for health management after discharge. The control group were treated with oral and written follow-up rehabilitation exercise programs only at the time of discharge, and took outpatient or telephone follow-up 1, 2, and 3 months after discharge. The baseline data of the two groups were compared. The functional rehabilitation indicators of the two groups were analyzed 1, 2, and 3 months after the surgery. t test, repeated measure analysis of variance, χ² test, or Freeman-Halton test were applied. Results　All the patients in both groups were followed up; no one missed the follow up or died. One, two, and three months after the surgery, the scores of Function Independent Measure (FIM) and Short Physical Performance Battery (SPPB) in the observation group were lower than those in the control group [(63.38±3.78) vs. (56.50±4.47), (76.44±3.41) vs. (65.72±4.13), (98.68±8.89) vs. (89.20±8.22), (4.32±0.59) vs. (2.84±0.62), (7.10±0.58) vs. (4.90±0.51), and (9.38±0.70) vs. (7.40±0.67)]; the scores of FIM and SPPB of the two groups gradually improved with time; there were statistical differences (F_{between groups}=135.585 and 484.430; F_time=904.260 and 2 011.030; all P<0.05). One, two, and three months after the surgery, the TUG test times and scores of Hospital Anxiety and Depression Scale (HADS) and Visual Analogue Scale (VAS) in the observation group were lower than those in the control group [(66.70±5.41) s vs. (97.84±3.99) s, (39.92±4.24) s vs. (63.24±6.28) s, (12.58±3.05) s vs. (23.78±4.23) s, (8.18±0.87) vs. (10.70±1.43), (4.66±0.82) vs. (7.70±0.99), (1.24±0.87) vs. (4.74±0.78), (3.44±0.54) vs. (4.48±0.50), (1.42±0.50) vs. (2.54±0.50), and (1.40±0.49) vs. (1.56±0.73)]; the TUG test times and scores of HADS and VAS of the two groups gradually decreased with time; there were statistical differences (F_{between groups}=1 599.893, 503.140, and 177.898; F_time=4 836.303, 1 060.010, and 943.972; all P<0.05). The interaction effect of time and group on TUG test and scores of SPPB and HADS were statistically significant (F_interaction=118.780, 11.830, and 6.060; all P<0.05). Conclusions　Tele-rehabilitation intervention based on mobile medical APP application provides a new feasible and effective home rehabilitation option for elderly patients with hip fractures, and greatly improves the effect of community rehabilitation after discharge, so it is worthy of clinical application.

Key words:

Telerehabilitation, Mobile medicine, Hip fractures, Elderly patients, Community-based rehabilitation