The effects of habitual functional training on physical functioning in patients after hip fracture: the protocol of the HIPFRAC study

Heiberg, Kristi Elisabeth; Bruun‐Olsen, Vigdis; Bergland, Astrid

doi:10.1186/s12877-016-0398-8

Cited by 19 publications

(20 citation statements)

References 45 publications

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“…Two trials recruited residents with cognitive impairment only (Neyens 2009; Shaw 2003). In addition, two trials (Becker 2003; Jensen 2002) carried out pre-planned subgroup analyses by levels of cognition, which are reported in Rapp 2008 and Jensen 2003, respectively. Cognitive impairment was defined differently in all four studies ( see footnotes to Analysis 14.1 and Analysis 14.2).…”

Section: Resultsmentioning

confidence: 99%

“…Other meta-analyses included in Stubbs 2015 and published since 2012 were Choi 2012, Guo 2014 and Santesso 2014. Choi 2012 pooled three studies conducted in care settings, all of which were included in this review: a vitamin D trial (Broe 2007), a multifactorial trial (Neyens 2009), and Rapp 2008, which is included as a subgroup analysis of Becker 2003 in our review. Guo 2014 conducted an 'exploratory meta-analysis' examining fall-prevention interventions for those with or without cognitive impairment in institutionalised and non-institutionalised settings.…”

Section: Discussionmentioning

confidence: 99%

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Interventions for preventing falls in older people in care facilities and hospitals

Cameron

Dyer²,

Panagoda

et al. 2018

Cochrane Database of Systematic Reviews

357

370

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Background Falls in care facilities and hospitals are common events that cause considerable morbidity and mortality for older people. This is an update of a review first published in 2010 and updated in 2012. Objectives To assess the effects of interventions designed to reduce the incidence of falls in older people in care facilities and hospitals. Search methods We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (August 2017); Cochrane Central Register of Controlled Trials (2017, Issue 8); and MEDLINE, Embase, CINAHL and trial registers to August 2017. Selection criteria Randomised controlled trials of interventions for preventing falls in older people in residential or nursing care facilities, or hospitals. Data collection and analysis One review author screened abstracts; two review authors screened full‐text articles for inclusion. Two review authors independently performed study selection, 'Risk of bias' assessment and data extraction. We calculated rate ratios (RaR) with 95% confidence intervals (CIs) for rate of falls and risk ratios (RRs) and 95% CIs for outcomes such as risk of falling (number of people falling). We pooled results where appropriate. We used GRADE to assess the quality of evidence. Main results Thirty‐five new trials (77,869 participants) were included in this update. Overall, we included 95 trials (138,164 participants), 71 (40,374 participants; mean age 84 years; 75% women) in care facilities and 24 (97,790 participants; mean age 78 years; 52% women) in hospitals. The majority of trials were at high risk of bias in one or more domains, mostly relating to lack of blinding. With few exceptions, the quality of evidence for individual interventions in either setting was generally rated as low or very low. Risk of fracture and adverse events were generally poorly reported and, where reported, the evidence was very low‐quality, which means that we are uncertain of the estimates. Only the falls outcomes for the main comparisons are reported here. Care facilities Seventeen trials compared exercise with control (typically usual care alone). We are uncertain of the effect of exercise on rate of falls (RaR 0.93, 95% CI 0.72 to 1.20; 2002 participants, 10 studies; I² = 76%; very low‐quality evidence). Exercise may make little or no difference to the risk of falling (RR 1.02, 95% CI 0.88 to 1.18; 2090 participants, 10 studies; I² = 23%; low‐quality evidence). There is low‐quality evidence that general medication review (tested in 12 trials) may make little or no difference to the rate of falls (RaR 0.93, 95% CI 0.64 to 1.35; 2409 participants, 6 studies; I² = 93%) or the risk of falling (RR 0.93, 95% CI 0.80 to 1.09; 5139 participants, 6 studies; I² = 48%). There is moderate‐quality evidence that vitamin D supplementation (4512 particip...

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Interventions for preventing falls in older people in care facilities and hospitals

Cameron

Dyer²,

Panagoda

et al. 2018

Cochrane Database of Systematic Reviews

357

370

View full text Add to dashboard Cite

show abstract

“…The subjects initially participated in an ongoing randomized controlled study where the effects of habitual functional training, initiated by the research physiotherapist and performed by the nurses during short-term stays, were compared to usual care [ 21 ]. In the randomized study, a total of 160 patients are to be included.…”

Section: Methodsmentioning

confidence: 99%

“…There do not seem to be one set of guidelines for hip fracture rehabilitation after discharge from hospital [ 18 – 20 ]. We have therefore initiated and started to enroll patients in a randomized controlled trial (RCT), the HIPFRAC study, to examine the effects of habitual functional training while the patients are at short-term stays in nursing homes before they are returning to home [ 21 ]. However, while standardized assessments capture valuable information on the patient’s physical and mental functioning, they may not capture information of relevance for the individual patients in their recovery process [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

“I struggle to count my blessings”: recovery after hip fracture from the patients’ perspective

Bruun‐Olsen¹,

Bergland²,

Heiberg³

2018

BMC Geriatr

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BackgroundRecovery outlooks of physical functioning and quality of life after hip fracture have not changed significantly over the past 25 years. Previous research has mainly dealt with causalities and acute treatment, while the recovery process from the patients’ perspective has been less comprehensively described. Expanded knowledge of what the patients consider important in their recovery process may have important consequences for how these patients are treated in the future and thereby on future patient outcomes. The aim presently is therefore to explore how elderly patients with hip fracture enrolled in an ongoing RCT have experienced their recovery process.MethodThe study was qualitative in design. Eight frail elderly in recovery after hip fracture (aged 69–91) were interviewed in their home four months after their fracture. The interviews covered issues related to their experiences of facilitators and barriers throughout the different stages in the recovery process. The patients were already enrolled in an ongoing randomized controlled trial, examining the effects of habitual functional training during their short term stays at nursing homes. The patients were chosen strategically according to age, gender, and participation in rehabilitation. The interviews were recorded, transcribed and subjected to a method of systematic text condensation inspired by Giorgi’s phenomenological method.ResultsThe results revealed that the patients’ experiences of the recovery process fell into three main themes: “Feeling vulnerable”, “A span between self-reliance and dependency” and “Disruption from a normal life”. The feeling of gloominess and vulnerability persisted throughout. Being in recovery was also experienced as a tension between self-reliance and dependency; a disrupted life where loss of mobility and the impact of age was profoundly present.ConclusionBeing in recovery after hip fracture was experienced as a life breaking event. Based on these findings, increased focus on individualized treatment to each patient through each stage of the recovery process should be emphasized.

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“…Hip fracture is a fracture of the upper part of the femur, and has high incidence in the elderly [ 1 ]. Hip fractures in aged people leads to high mortality, high risk of postoperative complication, and impaired quality of life [ 2 – 5 ].…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of the c-reactive protein/prognostic nutritional index ratio after hip fracture surgery in the elderly population

Ren

et al. 2017

Oncotarget

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BackgroundMore and more older patients receive the surgery after hip fracture. However, the mortality rate is high. Prognostic nutritional index (PNI) is associated with prognosis in hip fracture patients. In the current study, we proposed a novel prognostic score, named c-reactive protein/PNI ratio (CRP/PNI ratio), for predicting the prognosis for geriatric orthopedic population.MethodsThis is a prospective study. Eighty cases of hip fracture surgery in the elderly population were studied to reveal the relationship between the CRP/PNI ratio and the clinicopathological characteristics of the elderly patients. Clinical data included age, sex, weight, length of stay, duration of surgery, comorbidity, and biological data were collected. The primary endpoint was the 1-year mortality rate.ResultsCox regression and log-rank tests were used to evaluate the correlation of CRP/PNI to the one-year mortality. The one-year mortality rate was low in the patients with a low CRP/PNI ratio (P < 0.001). Univariate and multivariate survival analyses proved that CRP/PNI was an important factor to predict the one-year mortality rate of the geriatric hip fracture surgery patients.ConclusionLow CRP/PNI ratio was significantly associated with low one-year mortality rate in older patients after hip fracture surgery.

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The effects of habitual functional training on physical functioning in patients after hip fracture: the protocol of the HIPFRAC study

Cited by 19 publications

References 45 publications

Interventions for preventing falls in older people in care facilities and hospitals

Interventions for preventing falls in older people in care facilities and hospitals

“I struggle to count my blessings”: recovery after hip fracture from the patients’ perspective

Prognostic value of the c-reactive protein/prognostic nutritional index ratio after hip fracture surgery in the elderly population

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