MEASURING FUNCTIONAL RECOVERY FOLLOWING HIP FRACTURE IN THE SUB-ACUTE SETTING. Sandy B. Ganz* 1. Rehabilitation, Hospital for Special Surgery, NYC, NY; 2. Rehabilitation, Amsterdam Nursing Home, New York, NY PURPOSE: The purpose of this study was to describe the expected rate of recovery following hip fracture in the sub acute setting using performance based measures (PBM)and determine whether PBM are sensitive to change. BACKGROUNDS/SIGNIFICANCE: Hip fractures are associated with significant morbidity and mortality. In 1996 there were over 340,000 hospitalizations due to hip fracture. For those individuals who have sustained a hip fracture, returning to their pre-fracture status is a primary goal. Patients improve along a line of increasing ambulatory status, and often transition from acute care to sub acute care. It is necessary to determine what the expected rate of recovery is following hip fracture in the sub acute setting. SUBJECTS: There were 67 subjects, 11 males and 56 females ranging in age from 63-99, with a mean age of 85.2. There were 40 left hip fractures and 37 right hip fractures: 29 sustained femoral neck fractures, 31 intertrochanteric fractures and 7 subtrochanteric fractures. Thirty nine percent underwent an open reduction and internal fixation:57% underwent a hemiarthroplasty, and 3% underwent total hip arthroplsty. Average hospital stay was 10.2. Average sub acute stay was 32.2 days. METHODS AND MATERIALS: This was a prospective observational cohort. The study took place in a 409 bed skilled nursing facility iwth a 33 bed short term rehabilitation unit. Inclusion criteria was as follows: Over 60 years; resides in the community; ambulatory prior to hip fracture and able to follow 1 step commands in English or Spanish; fracture was a result of a mechanical fall; Underwent surgical repair. Exclusion criteria: Under 60 years old; resides in an institution;non ambulatory prior to hip fracture; unable to follow 1 step commands; fracture was the result of something other than a mechanical fall; Non surgical repair. All subjects received daily restorative physical therapy 30-45 minutes per day. Daily treatment consisted of transfer and gait training, muscle strengthening, balance, coordination and aerobic conditioning. The following performance based measures (PBM) were performed on admission to the nursing home, and weekly thereafter until discharge from physical therapy: Six minute walk test (6MW), Tinetti Gait and Balance Test, and Timed up and Go Test (TUG). ANALYSES: Statistical analysis was perfomed using the KWIKSTAT statistical software package. All continuous and categorical demographic data were recorded using standard methods. Descriptive statistics were used for baseline characteristics. Paired t-tests were used to comare admission and discharge scores. Repeated measures analysis was used to compare PBM over time. RESULTS: The patient profile for this study was a female (82%) living alone (53%), widowed(50%), Medicare recipient (63%). Fifty seven percent underwent a bipolar hemiarthroplasty following a femoral neck fracture (46%)whose postoperative weight bearing was weight bearing as tolerated (WBAT) 88%. There was significant improvement between the admission and discharge PBM scores. (Table1) Using repeated measures analysis,there were significant differences between TUG test scores at postoperative weeks 3,4 and 5 (Table 2) and signicant differences between 6MW test scores at postoperative weeks 3,4, and 5. CONCLUSIONS: The expected rate of recovery has been demonstrated utilizing specific performance based measures. We have shown that the 6MW test, TUG test and Tinetti Gait and Balance test is sensitive to change in the sub acute setting. FUNDING SOURCE: None KEYWORDS: Hip fracture, Performance Based Measures, Functional Outcome Comparison of Admission and Discharge PBM Scores Timed Up and Go Test - Repeated Measures Analysis-Postoperative weeks 3,4,5 Repeated Measures Analysis 6MW test Weeks 3,4,5 Copyright 2009 by the American Physical Therapy Association. Requests for reprints should be directed to the corresponding author of the article. Educators, students, and other academic customers may receive permission to reprint copyrighted material from Physical Therapy (ISSN 1538-6724) by contacting the Copyright Clearance Center Inc, 222 Rosewood Dr, Danvers, MA 01923. Other types of customers who want permission to reprint should contact the APTA Editorial Office, Attn: Physical Therapy.