Ocena podstawowych i złożonych czynności życia codziennego pacjentów geriatrycznych po zabiegu endoprotezoplastyki stawu biodrowego / Assessment of basic and instrumental activities of daily living in geriatric patients after total hip arthroplasty
Introduction: Osteoarthritis is one of the principal causes of motion organ disorder in old age. It also happens to be the main reason for a hip joint replacement surgery, by far the most frequently applied treatment for the over 65s. Advances in medical science and physical rehabilitation allow the elderly people to maintain high functional efficiency and self-reliance in performing everyday life activities.
Aim of the study: To offer an insight into the most frequently encountered problems in the pursuit of activities of daily living in geriatric patients after total hip arthroplasty. Additionally, the study also aimed to focus on the differences in overall functionality of the elderly persons relative to their age at the time of being subjected to total hip arthroplasty.
Material and methods: The study population consisted of 189 patients (123 women and 66 men) remaining in institutional care centres. Basic daily activities ADL scale and complex activities IADL scale were used for functional assessment. All study subjects were stratified by age (age range: Group I - 70 - 79 years; Group II - 80 years and over). Statistical analyses were completed with the aid of STATISTICA v10. package, and the Mann-Whitney test was applied to verification of working hypotheses, with statistical significance assumed at p = 0.05.
Results: The study subjects encountered the biggest problems in ADL with regard to unassisted bathing (43%) and in controlling the excretion of urine and stool (66.66%).
In IADL rational management of own finances proved most challenging for 71%, and over half of them (54%) was unable to venture out any further than for a short walk. When stratified by age, the main ADL score was not significantly different between the groups (5 points vs. 5 points; p > 0.05). Such differences were found in IADL, though (Group I - 20 points vs. Group II - 18 points; p < 0.05).
Conclusions: Within 4 weeks of undergoing a hip joint replacement the persons remaining in institutionalised care exhibited functional deficiencies in caring for personal hygiene. Effective training in performing the activities of daily living should be made a basic component of interdisciplinary approach in geriatric care, in due consideration of individual age constraints.
Financed by the National Centre for Research and Development under grant No. SP/I/1/77065/10 by the strategic scientific research and experimental development program:
SYNAT - “Interdisciplinary System for Interactive Scientific and Scientific-Technical Information”.