Hip Fractures Clinical Trial
Official title:
Early Rehabilitation After Hip Fracture: A Randomized Controlled Trial Comparing Different Vitamin D and Rehabilitation Programs
The aim of this study is to compare a low versus high intensity physiotherapy early
rehabilitation program combined with a low versus high dose vitamin D early rehabilitation
program in a randomized controlled trial among elderly patients with acute hip fracture in
an acute care setting. The primary outcome to be compared between treatment arms is the rate
of falls during a 12-month follow-up. Secondary outcomes are injurious falls, number of
persons who fell, low-trauma fractures (at the hip, forearm, humerus, pelvis, ankle, spine,
femur, tibia), disability, quality of life (Euro-Qol), mortality and health care
utilization. Another secondary outcome will be admission to nursing home compared between
treatment arms among subjects, who are community-dwelling prior to the index hip fracture.
Admission to nursing home is the marker of loss of independence for the individual, but also
triggers high cost for the society.
The study will provide new early rehabilitation guidelines to allocate health care resources
efficiently in the acute care setting. Eventually and most importantly, the study will help
improve outcomes in patients with hip fractures.
Subjects:
The researchers will enroll 204 elderly subjects (men and women) admitted to two large
hospital centers with acute hip fracture. Subjects may be institutionalized or
community-dwelling prior to admission. To be enrolled in the study subjects need to be 65
years or older. Demented persons, who reach a Folstein Mini Mental Status of less than 15
are excluded.
Design:
Once written informed consent from participants or proxies is given, subjects will be
randomly assigned to 4 different program combinations based on a 2X2 factorial design: (1)
low dose vitamin D / low intensity physiotherapy; or (2) low dose vitamin D / high intensity
physiotherapy; or (3) high dose vitamin D / low intensity physiotherapy; or (4) high dose
vitamin D / high intensity physiotherapy. Low dose Vitamin D is 800 IU cholecalciferol per
day and high dose vitamin D is 2000 IU cholecalciferol per day.
Subjects will be recruited within 5 days after hip fracture surgery and followed for adverse
outcomes over a 12-month period. Dose of vitamin D will be double-blinded.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Double-Blind, Primary Purpose: Prevention
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