Recovery of physical function after limb injuries in independent older people living at home

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Abstract
Objectives: to describe changes in physical functioning after fall‐related injuries to the limbs in independently living older people. Design: prospective cohort study, including a pre‐injury assessment and post‐injury assessments at 8 weeks and 5 and 12 months. Setting: the study is part of the larger, population‐based prospective and longitudinal Groningen Longitudinal Aging Study on the determinants of health‐related quality of life of people aged 57 and over, who are living independently in the north of the Netherlands. Subjects: 171 patients who sustained injuries at various sites on the limbs and who had completed all four assessments (66% of the eligible population). Patients were grouped according to injury site. Outcome measure: self‐reported grades of difficulties with performing basic and instrumental activities of daily living as measured by the Groningen Activity Restriction Scale. Results: 1 year after the injury, pre‐injury (mean) levels of functioning were not regained in any of the groups studied. However, only those with fractures of the wrist or hip experienced a substantial decrease in ability to perform basic and instrumental activities of daily living between baseline and the final assessment. Furthermore, of the 44 subjects with wrist fractures, seven (15.9%) needed help with at least one relevant activity at baseline and 18 (40.9%) at 12 months. Of the 34 subjects with hip fractures, four (11.8%) needed help with at least one activity at baseline and 18 (52.9%) at 12 months. Practically no changes were found in any of the groups after 5 months post‐injury. Conclusions: not only hip fractures, but also wrist fractures may reduce older people's chances of remaining independent. Prospects of further recovery are minimal 5–6 months after the injury.

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