Abstract
It is imperative that the surgical treatment of hip fractures is followed up with rehabilitation to enhance recovery and quality of life. This randomized controlled trial aimed to determine if an individualised, combined exercise–nutrition intervention significantly improved health outcomes in older adults, after proximal femoral fracture. We commenced the community extended therapy while in hospital, within two weeks post-surgery. The primary outcome was gait speed and secondary outcomes included physical function, strength and balance, body composition, energy and protein intake. Eighty-six and 89 participants were randomized into six months individualised exercise and nutrition intervention and attention-control groups, respectively. There were no statistically significant differences in gait speed between the groups at six and 12 months. There were no major differences between groups with respect to the secondary outcomes, except estimated energy and protein intake. This may be explained by the sample size achieved. Participants in the intervention group had greater increment in energy (235 kcal; 95% CI, 95 to 375; p = 0.01) and protein intake (9.1 g; 95% CI, 1.5 to 16.8; p = 0.02), compared with those in the control group at six months but not significant at 12 months. This study has demonstrated that providing early, combined exercise and nutrition therapy can improve dietary energy and protein intake in older adults with hip fractures.
Highlights
IntroductionHip fractures are strongly associated with poor quality of life and mortality, especially in frail, older adults [1,2]
Eighty-six and 89 participants were randomized into the intervention and attention-control groups, respectively
Follow-up data from 92% (79/86) of the intervention group and 87% (77/89) of the control group were available for analysis at six months (Figure 1)
Summary
Hip fractures are strongly associated with poor quality of life and mortality, especially in frail, older adults [1,2]. More than 30% of these older adults die within the first year of hip fracture [3,4]. This phenomenon suggests that hip fractures may be a symptom of frailty in this population, and the beginning of a downward spiral towards the end of life. Hip fractures have significant economic impacts on healthcare systems [5,6]
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