***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIMS To investigate whether a nutritional intervention in older women and men with femoral neck fracture had an effect on postoperative complications during hospitalization and on nutritional status at a four-month follow-up . METHODS The design was a r and omized controlled trial . The present study sample consisted of 157 patients aged 70 years and above with femoral neck fracture . The nutritional intervention included , among other things , a nutritional journal to detect nutrition deficiencies and protein-enriched meals for at least four days postoperatively . Further , at least two nutritional and protein drinks were served each day during the whole hospitalization and other factors that would influence the patient 's nutrition were also considered and dealt with . Postoperative complications were registered and patients were assessed using the Mini Nutritional Assessment ( MNA ) scale , including body mass index ( BMI ) , on admission and at a four-month follow-up . RESULTS Malnutrition was common and low MNA scores were associated with postoperative complications such as delirium and decubitus ulcers . There were significantly fewer days of delirium in the intervention group , seven patients in the intervention group developed decubitus ulcers vs. 14 patients in the control group and the total length of hospitalization was shorter . There were no detectable significant improvements regarding nutritional parameters between the intervention and the control group at the four-month follow-up but men improved their mean BMI , body weight and MNA scores in both the intervention and the control groups while women deteriorated in both groups . CONCLUSIONS Malnutrition was common among older people with hip fractures admitted to hospital . The nutritional intervention might have contributed to the patients suffering fewer days with delirium , fewer decubitus ulcers and shorter hospitalization but did not improve the long-term nutritional status , at least not in women . RELEVANCE TO CLINICAL PRACTICE This nutritional intervention , which was included in a multifactorial multidisciplinary intervention , is inexpensive and relatively easy to implement . It has significant effects on complications but no long-term effect on nutritional parameters , at least not in women OBJECTIVES to investigate the effectiveness of a  pharmacy discharge plan  in elderly hospitalized patients . DESIGN r and omized controlled trial . SUBJECTS AND SETTING S we r and omized patients aged 75 years and older on four or more medicines who had been discharged from three acute general and one long-stay hospital to a pharmacy intervention or usual care . INTERVENTIONS the hospital pharmacist developed discharge plans which gave details of medication and support required by the patient . A copy was given to the patient and to all relevant professionals and carers . This was followed by a domiciliary assessment by a community pharmacist . In the control group , patients were discharged from hospital following st and ard procedures that included a discharge letter to the general practitioner listing current medications . OUTCOMES the primary outcome was re-admission to hospital within 6 months . Secondary outcomes included the number of deaths , attendance at hospital outpatient clinics and general practice and proportion of days in hospital over the follow-up period , together with patients ' general well-being , satisfaction with the service and knowledge of and adherence to prescribed medication . RESULTS we recruited 362 patients , of whom 181 were r and omized to each group . We collected hospital and general practice data on at least 91 and 72 % of patients respectively at each follow-up point and interviewed between 43 and 90 % of the study subjects . There were no significant differences between the groups in the proportion of patients re-admitted to hospital between baseline and 3 months or 3 and 6 months . There were no significant differences in any of the secondary outcomes . CONCLUSIONS we found no evidence to suggest that the co-ordinated hospital and community pharmacy care discharge plans in elderly patients in this study influence outcomes Abstract Objective : To evaluate the effect of intensive geriatric rehabilitation on demented patients with hip fracture . Design : Preplanned sub analysis of r and omised intervention study . Settting : Jyväskylä Central Hospital , Finl and . Participants : 243 independently living patients aged 65 years or older admitted to hospital with hip fracture . Intervention : After surgery patients in the intervention group ( n=120 ) were referred to the geriatric ward whereas those in the control group were discharged to local hospitals . Main outcome measures : Length of hospital stay , mortality , and place of residence three months and one year after surgery for hip fracture . Results : The median length of hospital stay of hip fracture patients with moderate dementia ( mini mental state examination score 12 - 17 ) was 47 days in the intervention group ( n=24 ) and 147 days in the control group ( n=12 , P=0.04 ) . The corresponding figures for patients with mild dementia ( score 18 - 23 ) were 29 days in the intervention group ( n=35 ) and 46.5 days in the control group ( n=42 , P=0.002 ) . Three months after the operation , in the intervention group 91 % ( 32 ) of the patients with mild dementia and 63 % ( 15 ) of the patients with moderate dementia were living independently . In the control group , the corresponding figures were 67 % ( 28 ) and 17 % ( 2 ) . There were no significant differences in mortality or in the lengths of hospital stay of severely demented patients and patients with normal mini mental state examination scores . Conclusions : Hip fracture patients with mild or moderate dementia can often return to the community if they are provided with active geriatric rehabilitation OBJECTIVE To investigate the short- and long-term effects of a multidisciplinary postoperative rehabilitation programme in patients with femoral neck fracture . DESIGN AND SUBJECTS A r and omized controlled trial in patients ( n = 199 ) with femoral neck fracture , aged > or= 70 years . METHODS The primary outcomes were : living conditions , walking ability and activities of daily living performance on discharge , 4 and 12 months postoperatively . The intervention consisted of staff education , individualized care planning and rehabilitation , active prevention , detection and treatment of postoperative complications . The staff worked in teams to apply comprehensive geriatric assessment , management and rehabilitation . A geriatric team assessed those in the intervention group 4 months postoperatively , in order to detect and treat any complications . The control group followed conventional postoperative routines . RESULTS Despite shorter hospitalization , significantly more people from the intervention group had regained independence in personal activities of daily living performance at the 4- and 12-month follow-ups ; odds ratios ( 95 % confidence interval ( CI ) ) 2.51 ( 1.00 - 6.30 ) and 3.49 ( 1.31 - 9.23 ) , respectively . More patients in the intervention group had also regained the ability to walk independently indoors without walking aids by the end of the study period , odds ratio ( 95 % confidence interval ) 3.01 ( 1.18 - 7.61 ) . CONCLUSION A multidisciplinary postoperative intervention programme enhances activities of daily living performance and mobility after hip fracture , from both a short-term and long-term perspective BACKGROUND This report describes changes in eight areas of functioning after a hip fracture , identifies the point at which maximal levels of recovery are reached in each area , and evaluates the sequence of recuperation across multiple functional domains . METHODS . Community-residing hip fracture patients ( n = 674 ) admitted to eight hospitals in Baltimore , Maryl and , 1990 - 1991 were followed prospect ively for 2 years from the time of hospitalization . Eight areas of function ( i.e. , upper and lower extremity physical and instrumental activities of daily living ; gait and balance ; social , cognitive , and affective function ) were measured by personal interview and direct observation during hospitalization at 2 , 6 , 12 , 18 , and 24 months . Levels of recovery are described in each area , and time to reach maximal recovery was estimated using Generalized Estimating Equations and longitudinal data . RESULTS Most areas of functioning showed progressive lessening of dependence over the first postfracture year , with different levels of recovery and time to maximum levels observed for each area . New dependency in physical and instrumental tasks for those not requiring equipment or human assistance prefracture ranged from as low as 20.3 % for putting on pants to as high as 89.9 % for climbing five stairs . Recuperation times were specific to area of function , ranging from approximately 4 months for depressive symptoms ( 3.9 months ) , upper extremity function ( 4.3 months ) , and cognition ( 4.4 months ) to almost a year for lower extremity function ( 11.2 months ) . CONCLUSIONS Functional disability following hip fracture is significant , patterns of recovery differ by area of function , and there appears to be an orderly sequence by which areas of function reach their maximal levels This paper describes the results of a study of elderly patients admitted to hospital with fractured neck of femur , cerebral vascular accident or amputation of a lower limb who were , immediately post-crisis , transferred to a unit where nursing was perceived as the chief therapeutic activity . Patients ' outcomes were compared with a control group who followed a normal patient pathway , either remaining in an acute hospital ward until discharge or being transferred to a community hospital for part of their stay . The study was a modified replication of a small pilot study carried out between 1983 and 1985 Objective : To compare ambulation outcomes between home and institutional rehabilitation of patients with hip fracture . Design : R and omized controlled clinical equivalence trial . Setting : The Queen Elizabeth Hospital in Hong Kong . Subjects : Eighty-one patients with hip fracture . Intervention : Study group patients ( 40 ) were discharged directly home from the acute hospital and visited by a physiotherapist an average of 4.6 times . The control group subjects ( 41 ) were discharged to a rehabilitation centre for further treatment lasting on average 36.2 days ( SD 14.6 ) and they received physiotherapy daily . Main outcome measures : Ambulation ability measured on a categorical scale . Results : The mean age of the subjects was 75 years ( SD 8.3 years ) . Females comprised 60 % of all the subjects and majority were retired or home makers . Both groups of patients improved in their ambulation ability during their rehabilitation period but neither group achieved their pre-ambulatory status by the time of completion of the study . The study group achieved significantly higher ambulation scores ( p < 0.05 ) for community and household ambulation compared with the control group by the end of the study , a year after operation . Conclusion : Five visits by a physiotherapist in the patient 's home after discharge from an acute hospital after surgical treatment for hip fracture yielded better results in ambulation ability than one month of conventional institution-based rehabilitation Background : An orthopaedic management/patient‐focused care unit ( OMPFCU ) involving a dedicated orthopaedic – geriatrics liaison team was established at the Royal Brisbane Hospital in 1994 in an effort to safely accelerate rehabilitation of patients with proximal femoral fractures Des vieillards atteints de fracture du femur sont suivis pendant 1 an , avec ou sans traitement de reeducation specialisee . Survie a 1 an : 67 % des temoins , 81 % des malades reeduques . 69 % des malades reeduques peuvent vivre de nouveau dans leur ancien domicile , contre 39 % seulement des BACKGROUND Hospitals are under pressure from admissions of increasing numbers of older people . Older people may suffer unnecessary activity limitation after acute illnesses through lack of appropriate rehabilitation . OBJECTIVE To evaluate an early discharge and rehabilitation service for older people . DESIGN A r and omised controlled trial comparing an early discharge and rehabilitation with st and ard hospital aftercare . Outcome measures assessed at 3 and 12 months were the Barthel Index , Nottingham Extended Activities of Daily Living and EuroQol ( for patients ) the General Health Question naire ( for patients and carers ) . Use of services over 12 months was recorded . An interview study of patients and staff was conducted . SETTING AND INTERVENTION The early discharge and rehabilitation service offered a home-based rehabilitation and care programme for up to 4 weeks . PARTICIPANTS 370 hospitalised older medical and surgical patients were included in the r and omised controlled trial . Twenty patients and 11 staff were interviewed . RESULTS Subjects in the early discharge rehabilitation service group used fewer days in hospital at 3 months ( mean difference 9 , median difference 4 days , 95 % CI of median difference 2 - 8 ) . At 3 months the early discharge and rehabilitation service patients had better Barthel scores ( mean difference 1.2 , 95 % CI 0.4 - 1.9 ) , Nottingham Extended Activities of Daily Living kitchen scores ( mean difference 1.2 , 95 % CI 0.2 - 2.3 ) , Nottingham Extended Activities of Daily Living domestic scores ( mean difference 1.1 , 95 % CI 0.2 - 2.0 ) and General Health Question naire scores ( mean difference 2.4 , 95 % CI 0.7 - 4.1 ) . Significant Nottingham Extended Activities of Daily Living domestic and General Health Question naire benefits remained at 12 months . The early discharge and rehabilitation service carers had better General Health Question naire scores at 3 months ( mean difference 2.0 , 95 % CI 0.1 - 3.8 ) . The interviews suggested that the early discharge and rehabilitation service was patient-centred , set clear goals , worked as a team , and considered physical , psychological , social and environmental issues . It was found to be highly satisfactory . CONCLUSIONS Some older people can be discharged from hospital sooner , with better health outcomes using a well-staffed and organised patient-centred early discharge 
    Output:
    
Overall , the evidence indicates that multidisciplinary rehabilitation is not harmful .
While there was a tendency to a better overall result in patients receiving multidisciplinary inpatient rehabilitation  , these results were not statistically significant .