Effects of a Home-Based Physical Rehabilitation Program on Physical Disability After Hip Fracture: A Randomized Controlled Trial
Edgren, J., Salpakoski, A., Sihvonen, S. E., Portegijs, E., Kallinen, M., Arkela, M., Jäntti, P., Vanhatalo, J., Pekkonen, M., Rantanen, T., Heinonen, A., & Sipilä, S. (2015). Effects of a Home-Based Physical Rehabilitation Program on Physical Disability After Hip Fracture: A Randomized Controlled Trial. Journal of the American Medical Directors Association, 16(4), 350.e1-350.e7. https://doi.org/10.1016/j.jamda.2014.12.015
Julkaistu sarjassa
Journal of the American Medical Directors AssociationTekijät
Päivämäärä
2015Oppiaine
FysioterapiaGerontologia ja kansanterveysGerontologian tutkimuskeskusHyvinvoinnin tutkimuksen yhteisöPhysiotherapyGerontology and Public HealthGerontology Research CenterSchool of WellbeingTekijänoikeudet
© 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. This is a final draft version of an article whose final and definitive form has been published by Elsevier. Published in this repository with the kind permission of the publisher.
Objective
Fewer than half of the patients with hip fracture will regain the prefracture level of physical functioning. This secondary analysis of a randomized controlled trial investigated the effects of a multicomponent home-based rehabilitation program (ProMo) on physical disability after hip fracture.
Design
Randomized, controlled, parallel-group trial.
Setting
Rehabilitation in participants' homes; measurements in university-based laboratory and local hospital.
Participants
Population-based clinical sample of community-dwelling people older than 60 years (n = 81) operated for hip fracture were randomized into intervention and control groups.
Intervention
The year-long intervention aimed at restoring mobility. It included evaluation and modification of environmental hazards, guidance for safe walking, pain management, home exercise, physical activity counseling, and standard care.
Measurements
Physical disability was assessed by a questionnaire at baseline, and 3, 6, and 12 months thereafter. Sum scores were computed for basic (ADLs) and instrumental activities of daily living (IADLs). A higher score indicated more difficulty. GEE models were constructed to analyze the effect of the intervention.
Results
In the intention-to-treat analysis, no intervention effect was observed for sum scores. For the single disability items, borderline significant positive effects were observed for preparing food and handling medication (interaction P = .061 and P = .061, respectively). In the per-protocol analysis, the mean differences between groups were −0.4 points (SE 0.5), −1.7 (0.7), and −1.2 (0.7) at 3, 6, and 12 months for ADLs and −1.0 (1.2), −3.2 (1.5), and −2.5 (1.4) for IADLs, correspondingly.
Conclusion
The current analyses suggest that home-based rehabilitation may reduce disability among older people after hip fracture. The present results need to be confirmed in a study with larger sample size. Potentially a more task-oriented rehabilitation approach might gain more benefits. Current Controlled Trials (ISRCTN53680197).
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Julkaisija
Elsevier Inc.; American Medical Directors AssociationISSN Hae Julkaisufoorumista
1525-8610Asiasanat
Julkaisu tutkimustietojärjestelmässä
https://converis.jyu.fi/converis/portal/detail/Publication/24579997
Metadata
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