Functional Outcomes After Hip Fracture Rehabilitation Before and During the COVID-19 Pandemic: A Retrospective Comparative Study

Objectives: To compare functional recovery during inpatient rehabilitation, assessed by Functional Independence Measure (FIM) gain and FIM efficiency, between the pre-pandemic and COVID-19 pandemic periods in older adults after hip fracture. Methods: This retrospective observational study included patients aged ≥65 years who underwent hip fracture surgery between January 2016 and December 2022 and were admitted to a convalescent rehabilitation ward. Patients were categorized into the pre-pandemic (2016–2019) and pandemic (2020–2022) periods. Functional outcomes included total, motor, and cognitive FIM gain and FIM efficiency. Multiple linear regression analyses were performed to identify factors associated with rehabilitation outcomes. Results: A total of 650 patients were analyzed. Admission motor and total FIM scores were significantly lower during the pandemic, whereas cognitive FIM scores were similar between groups. After multivariable adjustment, total FIM gain and total FIM efficiency did not differ significantly between periods. Exploratory analyses showed no significant associations between the pandemic period and motor or cognitive FIM gain or efficiency. Conclusions: Although motor and total FIM scores at admission were lower during the pandemic period, no statistically significant differences in adjusted total FIM gain or total FIM efficiency were observed between the pre-pandemic and pandemic periods.