Abstract
IntroductionHip fractures are a major health problem globally and are associated with increased morbidity, mortality, and substantial economic costs. Successful operative treatment of hip fracture patients is necessary for the optimization of post-op mobility and functional recovery of the patient. Rehabilitation after surgical stabilization of a hip fracture is crucial in order to restore pre-fracture function and to avoid long-term institutionalization. In particular ongoing exercise which targets balance can prevent up to 40% of falls. Therefore, we have designed a post-discharge home-based physical rehabilitation intervention program to minimize disability and falls in this high-risk elderly population. Methods and analysisThe study will be an open label, simple randomized controlled trial at a single hospital. The two arms will be equally allocated on a 1:1 ratio into intervention and control groups. The control arm will receive the usual standard postoperative rehabilitation. The intervention group will receive an extended home-based rehabilitation program twice a week continued for 3 months (12 weeks) after discharge. The Primary outcome of the study is occurrence of falls. Falls will be measured at 3, 6, 12, and 24 months by research-assistant follow-up telephone calls for both the groups. Mobility-related disability will be measured with a self-reported test at every routine follow-up for up to two years using a performance-based short battery tool. Negative binomial regression model will be used to compare number of falls in both the groups by computing incidence ratio rates. Ethics and disseminationApproval for the conduction of this study has been taken from the Ethical Review Committee (ERC) of the institution. Evidences which will be obtained from this study will facilitate to propose changes in existing guidelines and policies for treating fall and hip fracture patients.Trial registrationThis trial is registered on clinicaltrials.gov ID: NCT04108793.
Highlights
Hip fractures are a major health problem globally and are associated with increased morbidity, mortality, and substantial economic costs
One in three older people experience one or more falls each year [1] and about one in six 50-year-old women will have at least one hip fracture before they die [2]. This propensity for fallrelated injury in elderly persons stems from a high prevalence of Abbreviations: THR, Total hip replacement; Clinical Trial Unit (CTU), Clinical trial unit; Ethical Review Committee (ERC), Ethical Review committee
Sadruddin Pidani et al / International Journal of Surgery Protocols 22 (2020) 24–28 based study conducted throughout the country concluded that currently there are 9.91 million people suffering from osteoporosis [8]
Summary
Falls and fractures in older people are of major public health significance. One in three older people experience one or more falls each year [1] and about one in six 50-year-old women will have at least one hip fracture before they die [2]. Sadruddin Pidani et al / International Journal of Surgery Protocols 22 (2020) 24–28 based study conducted throughout the country concluded that currently there are 9.91 million people suffering from osteoporosis [8] They further added that the numbers estimated will rise up to 11.3 million by 2020 and 12.91 million by 2050. A systematic review of 88 trials conducted in 2016 reports significant effect of home-based exercise program post-surgery on strengthening of leg muscles and overall functionality [11]. We have designed a post-discharge home-based physical rehabilitation intervention program to minimize disability and falls in this high-risk elderly population. This study will evaluate the effectiveness of 12 week home-based physiotherapy program in reduction of secondary falls and improvement in physical mobility of elderly patients after hip fracture surgery
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