Orthostatic hypotension and rehabilitation.

Orthostatic hypotension is a multifactorial clinical syndrome which occurs when standing blood pressure drops below prestanding levels. Orthostatic hypotension is common among the elderly, but its relation to falls, muscle strength and rehabilitation is not certain. By means of this study we will investigate if orthostatic hypotension is related to successful rehabilitation in patients with hip fractures. Main outcome parameters are orthostatic hypotension or orthostatic complains and muscular strength measured by Hand grip dynamometry.

The aim of this observational study is to investigate the relationship between orthostatic hypotension and the rate of successful rehabilitation. A previous study showed that orthostatic hypotension increased the risk for successful rehabilitation, but the definition of successful rehabilitation and other sources of bias may have caused this result. The relationship between rehabilitation, muscle strength and orthostatic hypotension will also be investigated.

- Pre-operative: Barthel questionnaire, GFI, Fear of Falling, Handgrip dynamometry
- post-operatively day 1 or 2: BP
- day of discharge hospital: BP, Handgrip dynamometry, MMSE
- day of discharge nursing home: Barthel, time to successful rehabilitation
- post-operatively 2 months (out-patient department): Barthel questionnaire, GFI, RR, Handgrip dynamometry
- post-operatively 6 and 12 months (questionnaire by telephone): number of fall incidents, Barthel questionnaire.
- Post-operatively 12 months: mortality and re-admissions.

- Blood pressure measurements (BP)
- Hand grip dynamometry