Physical activity after a hip fracture: effect of a multicomponent home-based rehabilitation program − a secondary analysis of a randomized controlled trial

Publication date: Available online 27 January 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Katri Turunen, Anu Salpakoski, Johanna Edgren, Timo Törmäkangas, Marja Arkela, Mauri Kallinen, Maija Pesola, Sirpa Hartikainen, Riku Nikander, Sarianna Sipilä
ObjectivesTo investigate the effect of a yearlong multicomponent rehabilitation program on the level of physical activity (PA) and the maintenance of the level of PA over one year follow-up among older people recovering from a recent hip fracture.DesignSecondary analysis of a randomized, controlled, parallel-group trial.SettingHome-based rehabilitation; measurements in university laboratory.ParticipantsCommunity-dwelling people aged 60+ recovering from a hip fracture. Participants were randomly assigned into an intervention (n=40) or control (n=41) group on average 42±23 days after discharge from hospital.MeasurementsThe outcome was the level of PA, which was assessed with the questionnaire (a modified Grimby scale) at baseline, and 3, 6, 12 and 24 months after baseline. Three PA categories were defined: inactivity, light PA and moderate to heavy PA. Physical function was assessed using the short physical performance battery (SPPB) at baseline. The effects of the intervention were analyzed with generalized estimation equations.InterventionA yearlong intervention included evaluation and modification of environmental hazards, guidance for safe walking, non-pharmacological pain management, a progressive home exercise program, PA counseling and Standard Care.ResultsIn the intervention group, a significant increase was observed in the level of PA after the intervention (interaction p=0.005) and after one-year follow-up (0.021) compared to the standard care only. The benefit was particularly evident among the participants with a baseline SPPB score seven or above (interaction p<0.001).ConclusionThe 12-month individualized multicomponent rehabilitation program increased PA among older hip fracture patients. The increase was found to be maintained at the one-year follow-up.



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