Hip Fracture Clinical Trial
Official title:
Efficacy of a Post-Rehabilitation Exercise Intervention
Background:
Many people who have suffered a hip fracture are discharged from rehabilitation services
with significant residual functional limitations and disability. We believe that a
home-based exercise program that incorporates cognitive-behavioral techniques to increase
exercise adherence and promote the return to daily activities could extend the benefits of
formal rehabilitation for patients who have suffered a hip fracture.
Specific Aims:
We will conduct a 5-year multi-site randomized controlled trial in patients who have
suffered a recent hip fracture and have completed all rehabilitation services. The specific
aim that this project will address is whether:
Participation in the Strong for Life (SFL) program will improve function and disability
outcomes in participants 6-months after they are discharged from rehabilitation services.
This study will also investigate the following secondary hypotheses:
1. Changes in function and disability at 6-month follow-up will be correlated with changes
in all three proposed intermediary variables: muscle strength, balance, and
self-efficacy.
2. The SFL program will significantly improve health-related quality of life among
participants at 6-month follow-up.
3. At 9-month follow-up the SFL program will continue to have a significant impact on
participants' function and disability compared to the control group.
Target population:
The target population will be people aged 60 years or more who have suffered a recent
traumatic hip fracture, have one or more residual functional limitations and have completed
all inpatient, outpatient or homecare rehabilitation services.
Intervention:
We will use an enhanced version of the Strong for Life program. This home-based exercise
program will include both resistance exercises using Thera-bands that will be shown on a
video/DVD and weight-bearing exercises that are progressed using a step and/or a weighted
vest. A cognitive-behavioral program that is customized for people recovering from hip
fracture is being developed that will focus on promoting exercise adherence, decreasing fear
of falling and increasing the return to daily activities in the patient's home and
community.
Design:
A randomized controlled clinical trial will be implemented to measure the efficacy of the
Strong for Life program. An attention-control intervention will be provided to all
participants assigned to the control group. The outcome evaluation points are:
- T0: baseline, at the point of discharge from formal rehabilitation;
- T2: 6-month outcome assessment
- T3: 9-month follow-up
Outcomes:
The primary outcomes will be function measured by both self-report (AM PAC) and physical
performance measures (SPPB). Secondary outcomes include disability, self-efficacy, balance,
strength, cognition, and reaction time. Adherence to the exercise program and adverse events
will also be monitored.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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