Provider: - Institution: - Data provided by Europeana Collections- Hip fractures in geriatrics are a major health problem, both for individuals and for the entire health care system. It is estimated that only half of those patients who were completely independent before fracture, becomes able to walk without aids, and even one-fifth must be permanently placed in institutions for the care of the elderly. The aim of this study was to determine the efficacy of the applied rehabilitaion proram on the recovery of patients older than 65 years after surgically treated hip fracture and to compare the effects of different rehabilitation programs. This prospective study was conducted on 203 patients admited on rehabilitation after operated hip fracture. Input parameters were gender, age, type of fracture, type of surgery, time since surgery and start of rehabilitation, duration of rehabilitation and comorbidity measured by Cumulative Illnese Rating Score for Geriatrics (CIRS-G). Functional recovery was evaluated by Berg Balance Scale (BBS) and the motor part of Functional Independance Measure (FIM). The quality of life was evaluated by SF-36v2 Health Survey. Values were recorded at admission, at discharge, 3 and 6 months after discharge. Patients were divided into two groups, one group that was treated in the rehabilitation program including balneotherapy and Group 2, in which the patients were treated without balneotherapy. The type of rehabilitation program determined the treating physician specialis of phzsical medicine and rehabilitation. Statistical analysis was preformed using Student's t test, Mann-Whitney U test, unifactorial ANOVA test, Pearson correlation. The results showed that all patients had a statistically significant improvement in functional recovery measured by the BBS and a motor FIM at discharge, and that this improvement took place, and after 3 and 6 months. Patients in group 1 showen at admission, discharge, and after 3 and 6 months statistically significantly better resoults than patients in group 2. Considering that the two groups except for the type of rehabilitation treatment differed according to the degree of co-morbidity (patients in Group 1 had fewer associated diseases) and by age (patients in Group 1 had a significantly lower average age) we tested significance and strength of the correlation of those three parameters with functional recovery and quality of life. The results showed that all three parameters significantly correlated with the functional recovery of patients and improving the quality of life and rehabilitation treatment showing the highest correlation, then the degree of comorbidity expressed by CIRS-G total score, and then the age. During the present study we found out that patients in Group 2 on folow up after 3 and 6 months show minimal progress, in the parameters of functional recovery and quality of life for most of the parameters of the SF-36 questionnaire, in contrast to the period during inpatient rehabilitation. Based on the present results we can conclude that investigated rehabilitation treatment showed high efficiency in all patients and therefore must be mandatory. Patients included in balneotherapy program show significantly better results in functional recovery and all the parameters of quality of life than patients who were not involved in this program of rehabilitation. The better recovery in the balneotherapy group was also due to the lower total CIRS-G and age.- Prelomi kuka predstavljaju veoma značajan medicinski problem, kako za pojedince tako i za čitav zdravstveni sistem. Procenjuje se da samo polovina pacijenata od onih koji su pre preloma bili potpuno nezavisni, biva osposobljeno do nivoa hoda bez pomagala, a čak jedna petina mora biti trajno smeštena u ustanove za brigu o starima. Cilj ovog rada je da da se utvrdi efikasnost primenjenog rehabilitacinog tretmana na opravak pacijenata starijih od 65 godina nakon operativno lečenog preloma kuka i da uporedi efekat različitih programa rehabilitacioniog tretmana. Ova prospektivna studija je sprovedena na 203 pacijenta stacionarno rehabilitovana nakon operativno lečenog preloma kuka. Ulazni parametri su bili pol, godine starosti, vrsta preloma, vrsta operacije, vreme proteklo od operacije do početka rehabilitacije, dužina trajanja rehabilitacije i komorbiditet meren kumulativnom skalom za gerijatrijsku populaciju (Cumulative Illnese Rating Score for Geriatrics CIRS-G) a praćeni su finkcionalni oporavak je vrednovan Bergovom skalom balansa (Berg Balance Scale BBS) i motornim delom testa funkcionalne nezavisnosti (motor Functional Independance measure FIM) dok je kvalitet života praćen preko upitnika SF-36. Vrednosti su beležene na prijemu, pri otpustu, 3 i 6 meseci nakon otpusta. Pacijenti su podeljeni u dve grupe, grupa 1 koja je bila tretirana u okviru rehabilitacionog programa balneoterapijiom i grupa 2 u kojoj su pacijenti bili tretirani bez balneoterapije. Vrstu rehabilitacionog programa je određivao ordinirajući fizijatar. U statističkoj obradi su korišćeni studentov T test, Mann-Whitney U test , unifaktorijelan ANOVA test, Pearsonova korelacija. Rezultati su pokazali da su svi pacijenti imali visoko statistički značajno poboljšanje u funkcionalnom oporavku merenom BBS-om i motornim FIM-om na kraju terapije i da se ovo poboljšanje održalo i nakon 3 i 6 meseci. Pacijenti iz grupe 1 su posmatrano na prijemu, otpustu, nakon 3 i 6 meseci bili visoko statistički značajno bolji od pacijenata iz grupe 2. Obzirom da su se ove dve grupe osim po vrsti rehabilitacionog tretmana razlikovali i po stepenu komorbiditeta (pacijenti iz grupe 1 su imali manje pridruženih bolesti) i po godinama starosti (pacijenti iz grupe 1 su imali statistički značajno niži prosek godina) ispitana je i značajnost i jačina korelacije ova tri parametra sa funkcionalnim oporavkom i poboljšanjem kvaliteta života. Dobijeni rezultati su pokazali da sva tri parametra visko statistički značajno koreliraju sa funkcionalnim oporavkom pacijenta i unapređenjem kvaliteta života i da rehabilitacioni tretman pokazuje najjaču korelaciju, zatim stepen komorbiditeta izražen CIRS-G total skorom, a zatim godine starosti. Tokom istraživanja utvrđena je i činjenica da pacijenti iz grupe 2 na kontrolama nakom 3 i 6 meseci u parametrima funkcionalnog oporavka i većini parametara kvaliteta života iz upitnika SF-36, pokazuju minimalan napredak, koji nije statistički značajan, za razliku od perioda tokom stacionarne rehabilitacije. Na osnovu izloženih rezultata možemo zaključiti da je ispitivani rehabilitacioni tretman pokazao visoku efikasnost kod svih pacijenta i da zato mora biti sastavi deo procesa lečenja. Pacijenti uključeni u program balneoterapije pokazuju znatno bolje rezultate u funkcionalnom oporavku i svim parametrima kvaliteta života, od pacijenata koji nisu bili uključeni u ovakav rehabilitacioni program. Osim balneoterapije bolji oporavak u grupi sa balneoterapijom je bio i posedica i manjeg komorbiditeta i godina starosti.Ovakvim pacijentima bi radi maksimalnog oporavka trebalo obezbediti nastavak rehabilitacionog programa u kućnim uslovima.- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana