Document Detail


Delivery and outcomes of a yearlong home exercise program after hip fracture: a randomized controlled trial.
MedLine Citation:
PMID:  21357809     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hip fracture affects more than 1.6 million persons worldwide and causes substantial changes in body composition, function, and strength. Usual care (UC) has not successfully restored function to most patients, and prior research has not identified an effective restorative program. Our objective was to determine whether a yearlong home-based exercise program initiated following UC could be administered to older patients with hip fracture and improve outcomes.
METHODS: A randomized controlled trial of 180 community dwelling female patients with hip fracture, 65 years and older, randomly assigned to intervention (n = 91) or UC (n = 89). Patients were recruited within 15 days of fracture from 3 Baltimore-area hospitals from November 1998 through September 2004. Follow-up assessments were conducted at 2, 6, and 12 months after fracture. The Exercise Plus Program was administered by exercise trainers that included supervised and independently performed aerobic and resistive exercises with increasing intensity. Main outcome measures included bone mineral density of the contralateral femoral neck. Other outcomes included time spent and kilocalories expended in physical activity using the Yale Physical Activity Scale, muscle mass and strength, fat mass, activities of daily living, and physical and psychosocial functioning. The effect of intervention for each outcome was estimated by the difference in outcome trajectories 2 to 12 months after fracture.
RESULTS: More than 80% of participants received trainer visits, with the majority receiving more than 3 quarters (79%) of protocol visits. The intervention group reported more time spent in exercise activity during follow-up (P < .05). Overall, small effect sizes of 0 to 0.2 standard deviations were seen for bone mineral density measures, and no significant patterns of time-specific between-group differences were observed for the remaining outcome measures.
CONCLUSION: Patients with hip fracture who participate in a yearlong, in-home exercise program will increase activity level compared with those in UC; however, no significant changes in other targeted outcomes were detected.
TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00390741.
Authors:
Denise L Orwig; Marc Hochberg; Janet Yu-Yahiro; Barbara Resnick; William G Hawkes; Michelle Shardell; J Richard Hebel; Perry Colvin; Ram R Miller; Justine Golden; Sheryl Zimmerman; Jay Magaziner
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Archives of internal medicine     Volume:  171     ISSN:  1538-3679     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-03-01     Completed Date:  2011-04-11     Revised Date:  2014-09-15    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  323-31     Citation Subset:  AIM; IM    
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00390741
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Delivery of Health Care
Exercise Therapy*
Feasibility Studies
Female
Hip Fractures / rehabilitation*
Humans
Program Evaluation
Treatment Outcome
Grant Support
ID/Acronym/Agency:
P30 AG028747/AG/NIA NIH HHS; P30 AG028747/AG/NIA NIH HHS; P30 AG028747-05/AG/NIA NIH HHS; P60 AG012583/AG/NIA NIH HHS; P60 AG012583-10/AG/NIA NIH HHS; P60 AG12583/AG/NIA NIH HHS; R01 AG017082/AG/NIA NIH HHS; R01 AG017082-04/AG/NIA NIH HHS; R01 AG018668/AG/NIA NIH HHS; R01 AG018668-04/AG/NIA NIH HHS; R01 AG17082/AG/NIA NIH HHS; R01 AG18668/AG/NIA NIH HHS; R37 AG009901/AG/NIA NIH HHS; R37 AG009901-13/AG/NIA NIH HHS; R37 AG09901/AG/NIA NIH HHS; T32 AG000262/AG/NIA NIH HHS; T32 AG000262-12/AG/NIA NIH HHS; T32 AG00262/AG/NIA NIH HHS
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