Occupational Adaptation Model Versus Biomechanical–Rehabilitation Model in the Treatment of Patients With Hip Fractures

Jackson, John P.; Schkade, Janette K.

doi:10.5014/ajot.55.5.531

Cited by 23 publications

(27 citation statements)

References 12 publications

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“…[78][79][80]91,148,180,191 Twenty studies compared intensive physical exercise with less intensive physical activity or an inactive control. 69,78,80,83,[91][92][93]104,[107][108][109][110]113,114,117,118,122,126,130,169 Twenty-four studies compared supervised programmes with conventional programmes that either did not include supervision as part of the programme or included only minimal supervision to ensure patient safety. 69,80,83,87,[91][92][93]104,[107][108][109][110][112][113][114]126,131,136,151,153,180,186,191,199 Nine studies compared specifically tailored programmes with generic rehabilitation programmes.…”

Section: Physical Activity Components Of the Rehabilitation Programmesmentioning

confidence: 99%

“…69,78,80,83,[91][92][93]104,[107][108][109][110]113,114,117,118,122,126,130,169 Twenty-four studies compared supervised programmes with conventional programmes that either did not include supervision as part of the programme or included only minimal supervision to ensure patient safety. 69,80,83,87,[91][92][93]104,[107][108][109][110][112][113][114]126,131,136,151,153,180,186,191,199 Nine studies compared specifically tailored programmes with generic rehabilitation programmes. 69,79,80,83,99,109,[113][114][115] Psychological components of the rehabilitation programmes Fourteen studies reported using a psychological intervention in isolation …”

Section: Physical Activity Components Of the Rehabilitation Programmesmentioning

confidence: 99%

“…69,80,83,87,[91][92][93]104,[107][108][109][110][112][113][114]126,131,136,151,153,180,186,191,199 Nine studies compared specifically tailored programmes with generic rehabilitation programmes. 69,79,80,83,99,109,[113][114][115] Psychological components of the rehabilitation programmes Fourteen studies reported using a psychological intervention in isolation 12,106,137,141,171,197,201 or as part of a comprehensive rehabilitation programme along with physical components. [78][79][80]91,148,180,191 Three of these studies 141,171,191 did not report any outcome data but were utilised mainly for theory explanation.…”

Section: Physical Activity Components Of the Rehabilitation Programmesmentioning

confidence: 99%

“…171,172 The majority of the studies included patients aged ≥ 65 years. 79,80,[82][83][84][85][86]88,[90][91][92][93]95,97,[99][100][101][102]105,107,109,111,113,115,116,120,121,[124][125][126][127]131,135,[138][139][140][141][142][143][144][145][146][147][148]151,153,[155][156][157]160,162,163,165,166,175,…”

Section: Summary Of Participant Characteristicsmentioning

confidence: 99%

“…The review included a total of 22,443 patients and 97 health professionals. In total, 6282 (range 90-401) patients participated in RCTs, 12,69,78,80,87,[128][129][130]197,199 276 (range 24-95) patients participated in quasi-RCTs, 83,[131][132][133] 116 (range 20-30) patients participated in non-RCTs, 79,[134][135][136][137] 3044 (range 1-919) patients participated in historical cohort studies, 13,[157][158][159][160][161][162][163][164][165]170,173,178 7136 (range 18-946) patients participated in concurrent cohort studies, 81,[138][139][140][141][142][143][144][145][146][147][148][149][150][151][152]169,177,179,…”

Section: Summary Of Participant Characteristicsmentioning

confidence: 99%

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Developing a multidisciplinary rehabilitation package following hip fracture and testing in a randomised feasibility study: Fracture in the Elderly Multidisciplinary Rehabilitation (FEMuR)

Williams

Roberts

Din

et al. 2017

Health Technol Assess

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BackgroundProximal femoral fracture is a major health problem in old age, with annual UK health and social care costs of £2.3B. Rehabilitation has the potential to maximise functional recovery and maintain independent living, but evidence of clinical effectiveness and cost-effectiveness is lacking.ObjectivesTo develop an enhanced community-based rehabilitation package following surgical treatment for proximal femoral fracture and to assess acceptability and feasibility for a future definitive randomised controlled trial (RCT) and economic evaluation.DesignPhase I – realist review, survey and focus groups to develop the rehabilitation package. Phase II – parallel-group, randomised (using a dynamic adaptive algorithm) feasibility study with focus groups and an anonymised cohort study.SettingRecruitment was from orthopaedic wards of three acute hospitals in the Betsi Cadwaladr University Health Board, North Wales. The intervention was delivered in the community following hospital discharge.ParticipantsOlder adults (aged ≥ 65 years) who had received surgical treatment for hip fracture, lived independently prior to fracture, had mental capacity (assessed by the clinical team) and received rehabilitation in the North Wales area.InterventionsParticipants received usual care (control) or usual care plus an enhanced rehabilitation package (intervention). Usual care was variable and consisted of multidisciplinary rehabilitation delivered by the acute hospital, community hospital and community services depending on need and availability. The intervention was designed to enhance rehabilitation by improving patients’ self-efficacy and increasing the amount and quality of patients’ practice of physical exercise and activities of daily living. It consisted of a patient-held information workbook, a goal-setting diary and six additional therapy sessions.Main outcome measuresThe primary outcome measure was the Barthel Activities of Daily Living (BADL) index. The secondary outcome measures included the Nottingham Extended Activities of Daily Living (NEADL) scale, EuroQol-5 Dimensions, ICEpop CAPability measure for Older people, General Self-Efficacy Scale, Falls Efficacy Scale – International (FES-I), Self-Efficacy for Exercise scale, Hospital Anxiety and Depression Scale (HADS) and service use measures. Outcome measures were assessed at baseline and at 3-month follow-up by blinded researchers.ResultsSixty-two participants were recruited (23% of those who were eligible), 61 were randomised (control,n = 32; intervention,n = 29) and 49 (79%) were followed up at 3 months. Compared with the cohort study, a younger, healthier subpopulation was recruited. There were minimal differences in most outcomes between the two groups, including the BADL index, with an adjusted mean difference of 0.5 (Cohen’sd = 0.29). The intervention group showed a medium-sized improvement on the NEADL scale relative to the control group, with an adjusted mean difference between groups of 3.0 (Cohen’sd = 0.63). There was a trend for greater improvement in FES-I and HADS in the intervention group, but with small effect sizes, with an adjusted mean difference of 4.2 (Cohen’sd = 0.31) and 1.3 (Cohen’sd = 0.20), respectively. The cost of delivering the intervention was £231 per patient. There was a possible small relative increase in quality-adjusted life-years in the intervention group. No serious adverse events relating to the intervention were reported.ConclusionsTrial methods were feasible in terms of eligibility, recruitment and retention, although recruitment was challenging. The NEADL scale was more responsive than the BADL index, suggesting that the intervention could enable participants to regain better levels of independence compared with usual care. This should be tested in a definitive Phase III RCT. There were two main limitations of the study: the feasibility study lacked power to test for differences between the groups and a ceiling effect was observed in the primary measure.Trial registrationCurrent Controlled Trials ISRCTN22464643.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 44. See the NIHR Journals Library for further project information.

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Section: Physical Activity Components Of the Rehabilitation Programmesmentioning

confidence: 99%

Section: Physical Activity Components Of the Rehabilitation Programmesmentioning

confidence: 99%

Section: Physical Activity Components Of the Rehabilitation Programmesmentioning

confidence: 99%

Section: Summary Of Participant Characteristicsmentioning

confidence: 99%

Section: Summary Of Participant Characteristicsmentioning

confidence: 99%

See 3 more Smart Citations

Developing a multidisciplinary rehabilitation package following hip fracture and testing in a randomised feasibility study: Fracture in the Elderly Multidisciplinary Rehabilitation (FEMuR)

Williams

Roberts

Din

et al. 2017

Health Technol Assess

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Proximal femoral fractures in the elderly: How are we measuring outcome?

Hutchings

Fox

Chesser

2011

Injury

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An occupation-based intervention in patients with hand-related disorders grouped using the sense of coherence scale—A randomized controlled trial

Hansen

Kristensen

Cederlund

et al. 2020

Journal of Hand Therapy

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Non-blinded randomized controlled trial Introduction: Occupation-based interventions are superior to physical exercise-based interventions in patients with activity limitations. However, only a few studies have examined the effect in patients with hand-related disorders. Patients recover heterogeneously, which could be due to personal factors, such as sense of coherence (SOC). Purpose: To investigate the effectiveness of an occupation-based intervention for patients with hand-related disorders and whether SOC can give an indication of the expected effects. Methods: A total of 504 patients were stratified into three SOC groups and then randomized to either an occupation-based intervention, including physical exercises (OBI), or a physical exercisebased intervention with occupation-focus (PEI). The primary outcome, functioning, was measured using the DASH questionnaire. Primary endpoint was at three months. Patients were followed for a year. Results: No significant difference was found in primary outcome analysis. Nevertheless, patients receiving OBI had a statistically significant and greater change in satisfaction with their occupational performance at one, two, and three months follow-up. Patients with a weak SOC had worse functioning and lower health-related quality of life than those in the other groups, at all times. Conclusions: OBI as delivered in this study was not superior to PEI in this patient group. However, in taking a client-centred approach, we recommend that OBI be based on individual needs, given that patients had a statistically greater change in score regarding satisfaction with their 2 occupational performance. It is evident that patients with a weaker SOC have a lower level of functioning. This knowledge should inform clinical practice. Level of Evidence: 2b * DASH, SOC, EQ-5D only calculated for 503 patients. One patient with strong SOC in EPI group withdrew before 1 month follow-up and therefore baseline data for this participant were excluded from baseline data. **only calculated on acute injuries

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Occupational Adaptation Model Versus Biomechanical–Rehabilitation Model in the Treatment of Patients With Hip Fractures

Abstract: Both groups benefited from occupational therapy intervention. Occupational Adaptation was associated with a more efficient outcome and greater patient satisfaction.

Cited by 23 publications

References 12 publications

Developing a multidisciplinary rehabilitation package following hip fracture and testing in a randomised feasibility study: Fracture in the Elderly Multidisciplinary Rehabilitation (FEMuR)

Developing a multidisciplinary rehabilitation package following hip fracture and testing in a randomised feasibility study: Fracture in the Elderly Multidisciplinary Rehabilitation (FEMuR)

Proximal femoral fractures in the elderly: How are we measuring outcome?

An occupation-based intervention in patients with hand-related disorders grouped using the sense of coherence scale—A randomized controlled trial

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