Original article
Effects on Function and Quality of Life of Postoperative Home-Based Physical Therapy for Patients With Hip Fracture

https://doi.org/10.1016/j.apmr.2005.04.020Get rights and content

Abstract

Tsauo J-Y, Leu W-S, Chen Y-T, Yang R-S. Effects on function and quality of life of postoperative home-based physical therapy for patients with hip fracture.

Objective

To evaluate the effects of a 3-month home-based physical therapy (PT) program for patients with hip fracture after surgery.

Setting

Home.

Participants

Twenty-five patients recently discharged from an acute orthopedic department.

Interventions

Patients were randomized to the home-based PT group (n=13), where they received home-based PT 8 times from discharge to month 3 postdischarge, or to the control group (n=12). The home-based PT program included exercises for muscle strengthening, range of motion (ROM), balance, and functional training. Patients in the control group were instructed to practice the exercise program given at bedside before discharge.

Main Outcome Measures

Patients were evaluated for hip ROM, strength, walking velocity, Harris hip score, and health-related quality of life (HRQOL) at the week of discharge and at 1, 3, and 6 months after discharge.

Results

The baseline characteristics showed no difference between the 2 groups. Harris score of the home-based PT group progressed from 58.6±8.5 to 90.1±5.4 at month 3, whereas Harris score of the control group progressed from 54.6±14.5 to 77.4±10.0 (P<.01). Scores of the psychologic domain of HRQOL for the home-based PT group were significantly better at month 1 (P<.05) and month 3 (P<.01) after discharge. Moreover, the physical domain score of the home-based PT group was also significantly better (P<.05) at 3 months after discharge.

Conclusions

Home-based PT programs could help patients regain function and HRQOL earlier.

Section snippets

Participants

Patients with hip fracture having surgery in our hospital from October 1, 2000, to September 30, 2001, were recruited with the agreement of each patient and his/her surgeon. The exclusion criteria included (1) patient or family rejected further treatment and follow-up after discharge, (2) patient was unable to complete the entire follow-up because of transportation problems (this study recruited patients who lived in the neighborhood of our hospital), (3) patient was unable to cooperate because

Patient Flow

A total of 54 patients were recruited in this study. Twenty-eight were in the home-based PT group, and 26 were in the control group. Because of the loss of follow-up and poor exercise compliance, there were ultimately only 13 patients in the home-based PT group and 12 in the control group (fig 1).

Participants’ Baseline Data

Table 1 lists the basic demographic and medical data of both groups. The preadmission parameters (age, sex, prefracture function, causes and types of fracture, waiting time for operation), length of

Discussion

The functional outcome and HRQOL were significantly better in the home-based PT group at follow-up. Patients in the home-based PT group recovered earlier and most of their recovery was found between 1 and 3 months after discharge, but patients in the control group recovered mostly between 3 and 6 months after discharge.

The study by Meeds and Pryor13 investigated the speed and degree of recovery of preinjury independence and returning to residence, and their home rehabilitation group recovered

Conclusions

The home-based PT program is associated with earlier functional recovery and HRQOL than usual care in Taiwan. These findings may have implications not only for clinical practice but also for public health and insurance policy.

Acknowledgment

We appreciate the kind help from the Department of Orthopaedics, National Taiwan University Hospital, for their referral of patients.

References (20)

There are more references available in the full text version of this article.

Cited by (82)

  • Efficacy and cost-effectiveness analysis of post-acute care for elderly patients with hip fractures

    2022, Journal of the Formosan Medical Association
    Citation Excerpt :

    PAC aimed to maximize functional recovery after acute crisis through intense rehabilitation. Both PAC settings had positive effects on the functional recovery that were consistent with previous studies.7–14 Shyu et al.11 found that the patients in the interdisciplinary home rehabilitation had higher scores than those in usual care by 8–10 BI points at 1 month after discharge.

  • Genotype, resilience and function and physical activity post hip fracture

    2019, International Journal of Orthopaedic and Trauma Nursing
    Citation Excerpt :

    Engaging in functional tasks and exercise post hip fracture has been shown to improve recovery and prevent or reduce the functional decline that can otherwise occur (Chudyk et al., 2009; Moayyeri, 2008; Pahikanti and Von Ah, 2012; Pedersen et al., 2013). It has been repeatedly shown that strength training and walking programs improve function, enhance strength and aerobic capacity, and prevent disability among those who sustained hip fractures (Binder et al., 2004; Latham et al., 2014; Tsauo et al., 2005). Although known to be beneficial, there are many challenges to engaging older adults in functional tasks or exercise (Benedetti et al., 2009; Browning et al., 2009).

View all citing articles on Scopus

Supported by the National Science Council (grant nos. NSC-89-2320-B-002-051-M5, NSC-90-2320-B-002-012-M56).

No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

View full text