Home rehabilitation after hip fracture. A randomized controlled study on balance confidence, physical function and everyday activities

Abstract

This study indicates that home rehabilitation, focused on supported discharge and enhancing self-efficacy, improves balance confidence, independence and physical activity in community-dwelling older adults in the early phase after hip fracture.

Effects of a Multicomponent Home-Based Physical Rehabilitation Program on Mobility Recovery After Hip Fracture: A Randomized Controlled Trial

“…Ten previously published multi-component home-based rehabilitation studies after a hip fracture, which investigated the effects of rehabilitation on mobility recovery compared to usual care, were found (Crotty et al 2002, Crotty et al 2003, Latham et al 2014, Shyu et al 2010, Tseng, Shyu & Liang 2012, Tinetti et al 1999, Ziden, Frandin & Kreuter 2008, Ziden, Kreuter & Frandin 2010. The studies include seven different trials, and from those, three trials included two separate papers.…”

“…Two of the trials started before discharge from hospital, and included a geriatric consultation and supported discharge (Shyu et al 2010, Ziden, Frandin & Kreuter 2008. The multi-component home rehabilitations included physical therapy, usually including strength, balance and stretching exercises, and in a few cases home environmental modifications.…”

“…Only some long-term home-based rehabilitation interventions targeting mobility recovery after hip fracture have been published (Crotty et al 2002, Latham et al 2014, Shyu et al 2010, Tinetti et al 1999, Ziden, Frandin & Kreuter 2008. We found seven trials in which the effects of an intervention on mobility were assessed.…”

“…Ten previous studies on seven different trials have been conducted (Crotty et al 2002, Crotty et al 2003, Latham et al 2014, Shyu et al 2010, Tinetti et al 1999, Tseng, Shyu & Liang 2012, Ziden, Frandin & Kreuter 2008, Ziden, Kreuter & Frandin 2010, but evidence of the effects on mobility limitation and disability remains conflicting.…”

Maintaining independence after a fall

“…A number of trials have favourably compared the outcomes of home-based rehabilitative therapy with care provided in either a hospital or other institutional setting. [37][38][39] Benefits of home-based rehabilitation have included improved physical independence, 38 confidence in avoiding subsequent falls, 38 lower caregiver burden at 12 months 38 and lower functional decline. 39 However, care of the patient is transferred onto either their family or members of the community, meaning that this option is only feasible if adequate social support networks are available.…”