Recovery of physical function after hip fracture: Analysis of secondary outcomes from a randomized controlled trial

Hirmand Nouraei MASc; Anna M. Chudyk; Wendy L. Cook; Pierre Guy; Penny Brasher; Joseph H. Puyat; Maureen C Ashe; Hirmand Nouraei MASc; Anna M. Chudyk; Wendy L. Cook; Pierre Guy; Penny Brasher; Joseph H. Puyat; Maureen C Ashe

doi:10.3934/medsci.2018.3.268

AIMS Medical Science

2018, Volume 5, Issue 3: 268-283. doi: 10.3934/medsci.2018.3.268

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Research article

Recovery of physical function after hip fracture: Analysis of secondary outcomes from a randomized controlled trial

1.
The University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada
2.
Centre for Hip Health and Mobility, 7F-2635 Laurel Street, Vancouver, BC V5Z 1M9, Canada
3.
Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, 454-6 -753 McDermot Avenue, Winnipeg, MB R3E0T6, Canada
4.
Division of Geriatric Medicine, UBC Department of Medicine, 7th floor, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
5.
Providence Healthcare, 9B-St. Paul’s Hospital, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada
6.
UBC Department of Orthopaedics, 3114-910 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada
7.
Centre for Clinical Epidemiology and Evaluation, 7th Floor, 828 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada
8.
Centre for Health Evaluation & Outcome Sciences, 588-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada
9.
Department of Family Practice, The University of British Columbia (UBC), 320-5950 University Boulevard, Vancouver, BC V6T 1Z3, Canada

Received: 02 March 2018 Accepted: 19 June 2018 Published: 06 July 2018

Purpose: To evaluate the effect of comprehensive geriatric management on physical function after hip fracture. Materials and methods: This was a parallel-group 1:1 single-blinded randomized controlled trial. Fifty-three older adults (≥ 65 years) 3 to 12 months after hip fracture were randomized through a web-based system (independent statistical company) into usual care or usual care plus intervention (B4). The B4 group received management by a geriatrician, physical therapist and other health professionals. Outcomes were: Leg (knee extension) and grip strength, timed up and go; and self-report function at baseline, 6 and 12 months (blinded assessment). We estimated between-group differences at 6 and 12 months using linear mixed models, and compared function between groups with a global statistical test (incorporating the five measures). Results: There were no statistically significant differences between groups. For the combined sample, strength on the fractured leg (2.63, 95% CI: 0.86, 4.40 kg) and non-fractured leg (1.36, 95% CI: 0.12, 2.70 kg) were statistically higher than baseline values. Conclusions: There were no between group differences in physical function. Overall, older adults from both groups had small significant improvements in bilateral leg strength at final assessment, but below age-matched normative values.
- activities of daily living,
- femoral fracture,
- functional outcome,
- muscle strength,
- rehabilitation
Citation: Hirmand Nouraei MASc, Anna M. Chudyk, Wendy L. Cook, Pierre Guy, Penny Brasher, Joseph H. Puyat, Maureen C Ashe. Recovery of physical function after hip fracture: Analysis of secondary outcomes from a randomized controlled trial[J]. AIMS Medical Science, 2018, 5(3): 268-283. doi: 10.3934/medsci.2018.3.268

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Abstract

Purpose: To evaluate the effect of comprehensive geriatric management on physical function after hip fracture. Materials and methods: This was a parallel-group 1:1 single-blinded randomized controlled trial. Fifty-three older adults (≥ 65 years) 3 to 12 months after hip fracture were randomized through a web-based system (independent statistical company) into usual care or usual care plus intervention (B4). The B4 group received management by a geriatrician, physical therapist and other health professionals. Outcomes were: Leg (knee extension) and grip strength, timed up and go; and self-report function at baseline, 6 and 12 months (blinded assessment). We estimated between-group differences at 6 and 12 months using linear mixed models, and compared function between groups with a global statistical test (incorporating the five measures). Results: There were no statistically significant differences between groups. For the combined sample, strength on the fractured leg (2.63, 95% CI: 0.86, 4.40 kg) and non-fractured leg (1.36, 95% CI: 0.12, 2.70 kg) were statistically higher than baseline values. Conclusions: There were no between group differences in physical function. Overall, older adults from both groups had small significant improvements in bilateral leg strength at final assessment, but below age-matched normative values.

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