Researchers at Seoul National University Bundang Hospital (SNUBH) have discovered that the Korean-version fragility fracture integrated rehabilitation management (FIRM) system is effective in treating elderly with hip fracture.

Professor Im Jae-young

As age increases, the muscle mass, muscle strength and rate of reaction decrease, which in turn, raises the risk of falling that can lead to hip fractures.

When a hip fracture occurs, patients have a hard time moving their body, while the low metabolism exposes them to various complications that can increase the patient’s mortality rate.

According to the hospital, the number of patients with hip fracture has dramatically increased in Korea due to the aging of the population, while the mortality rate within one year after hip fracture is as high as 16 percent.

In particular, patients with sarcopenia, which is a symptom where the patient’s muscle size and strength decrease due to aging, may have adverse outcomes even after surgery. Studies have shown that the 1-year mortality rate of patients with sarcopenia is 1.8 times higher than those who do not have the symptom.

To help patients with hip fractures with sarcopenia, the team, led by Professor Im Jae-young of the department of rehabilitation medicine, developed a FIRM tailored for Koreans that also follow international protocol and tested it on patients.

Compared to conventional simple rehabilitation which focuses on physical exercise and simple gait training, FIRM is a comprehensive and integrated program comprehensive intensive rehabilitation program that includes physical and occupational therapy, fall prevention education and post-discharge management under a short- or long-term rehabilitation plan to restore walking ability and other bodily functions after an elderly experiences a vulnerable fracture.

The researchers divided 68 patients who underwent hip fracture surgery into two groups according to the presence (32) or absence (36) of sarcopenia using the Asian Working Group of Sarcopenia (AWGS) standard.

After the FIRM treatment, the results of the follow-up study showed that the FIRM treatment improved the quality of life as well as walking, balance, and daily life activities in both groups.

“In the past, patients who had pre-operative sarcopenia were expected to have poor functional performance after walking because of poor walking ability and physical function,” Professor Im said. “However, this study showed that patients with sarcopenia showed functional improvement that was also almost equal to patients without sarcopenia.”

European Geriatric Medicine published the results of the study.

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