Effectiveness of Multicomponent Home-Based Rehabilitation in Elderly Patients after Hip Fracture Surgery: A Randomized Controlled Trial.

Abstract

This randomized controlled study aimed to assess the clinical effectiveness of an 8-week personalized multicomponent home-based rehabilitation (MHR) program by comparing it with a home exercise program after discharge. Forty patients (≥60 years old) who underwent hip surgery were randomly assigned to multicomponent home-based rehabilitation (MHR) and home exercise groups. The MHR program included strength, endurance, balance, and breathing exercises; modifications to the home environment; education on assistive device use; pressure ulcer care; nutrition management; and motivational counseling. The MHR group received 24 visits from rehabilitation staff for 8 weeks (3 times a week), while the home exercise group received home exercises focusing on strengthening described in the leaflet. The rehabilitation staff prescribed the intensity of exercise at the first visit, and the home exercise group exercised without supervision after that for 8 weeks. Both groups received a 10-min phone call once a week for overall counseling to ensure high adherence to home exercises. Among the 40 participants, 29 (72.5%) completed the trial. The primary outcomes were balance and mobility. Balance was assessed using the functional reach test (FRT), and the timed up-and-go test (TUG) was used to assess balance and mobility. Data were analyzed using the intention-to-treat principle. The MHR group showed significant improvement compared to the home exercise group for FRT (mean difference (MD) 4.4 cm; 95% confidence interval (CI) 1.0 to 7.8) and TUG (MD: −4.2 s; 95% CI −8.0 to −0.3) after 8 weeks of intervention. Subjective pain and physical components of general health-related quality of life also improved significantly in the MHR group. No serious adverse events related to the interventions were observed. The eight-week of MHR program can effectively improve balance and mobility.