Objective-To determine the feasibility of body weight-supported treadmill training (BWSTT) as a strategy for improving independent ambulation among patients who had sustained a hip fracture.
Design-Nonrandomized controlled trial.
Setting-Inpatient rehabilitation.Participants-Patients with a stable hip fracture and at least 50% weight-bearing.
Intervention-BWSTT in lieu of standard walking exercises throughout stay in rehabilitation.Main Outcomes Measures-Feasibility outcomes included the number of patients agreeing to participate in treadmill walking, the number who returned for follow-up assessments, compliance, and the number of adverse events. Secondary outcomes included the Lower Extremity Functional Scale, the Timed Up & Go test, a 2-minute walk test, and the Falls Self-Efficacy Scale. Univariate regression was used to assess the group effect on score changes from baseline to discharge and from baseline to follow-up.Results-Among 41 potentially eligible patients, 21 (51%) agreed to participate and 14 returned for follow-up assessments. The recruitment goal of 12 patients agreeing to BWSTT was achieved; however, retention by 3-month follow-up was 67%. The average compliance was 3 sessions a week; however, several patients were below average. No adverse events of BWSTT were reported. There were no significant differences between groups with respect to secondary outcomes.Correspondence to Lora Giangregorio, PhD, Department of Kinesiology, University of Waterloo, 200 University Ave W, Waterloo, ON, N1H 8K4, lmgiangr@healthy.uwaterloo.ca. Clinical trial registration no.: NCT00197496.Reprints are not available from the author.No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated. Ambulatory capacity is a predictor of returning home after discharge after hip fracture. 6,7 Mobility may be linked to lower extremity function; power of the leg extensors in the fractured leg has been positively associated with walking speed and stair-climbing time among patients after hip fracture. 8,9 Current strategies for training independent ambulation involve muscle strengthening, weight shifting, and balance exercises, as well as walking with or without assistive aids, generally in the hallways of inpatient units. Patients with hip fracture may not be allowed to bear full body weight initially, 10 which may be difficult for rehabilitation providers to control during walking exercises. Although participation in an inpatient rehabilitation program can achieve improvements in mobility, many patients with hip fracture remain dependent in transfers and locomotion at discharge. 10,11 Further, patients with a hip fracture continue to experience functional impairment a year after the fracture.
12,13A Cochrane review highlighted the paucity of evidence for rehabilitation strategies aimed at improving mobility after hip fracture. 14 BWSTT may be a useful method for retraini...