Improvement in Aerobic Fitness During Rehabilitation After Hip Fracture

Abstract

Mendelsohn ME, Overend TJ, Connelly DM, Petrella RJ. Improvement in aerobic fitness during rehabilitation after hip fracture. Objective To evaluate the effect of an upper-body exercise program on cardiorespiratory fitness in older adults with hip fracture during inpatient rehabilitation. Design Randomized controlled trial using a convenience sample. Setting An inpatient rehabilitation unit. Participants Twenty older patients (age, 81.3±7.2y; 14 women). Intervention Patients were randomly assigned to a control group (n=10) or a training group (n=10). Both groups attended physical and occupational therapy sessions 5 times a week during rehabilitation (mean length of stay, 32.9±5.3d). Patients in the training program used an arm crank ergometer 3 times a week for 4 weeks. Main Outcome Measure Peak oxygen consumption (V o 2peak). Results V o 2peak increased significantly in the training group (8.9±1.4 to 10.8±1.7mL·kg −1·min −1) and did not change in the control group (8.9±1.2 to 8.8±1.6mL·kg −1·min −1). At discharge, both groups were significantly improved in all functional outcome measures (Timed Up & Go [TUG] test, Berg Balance Scale [BBS], FIM instrument, two-minute walk test [2MWT], and ten-minute walk test [10MWT]). The training group performed significantly better in mobility (TUG, 2MWT, 10MWT) and balance (BBS) compared with the control group. There was a significant correlation between V o 2peak and the 2MWT ( r=.81) and 10MWT ( r=.85) in the training group at discharge. Conclusions The upper-body exercise program had a significant effect on aerobic power. Our results suggest that aerobic endurance exercise should be integrated into standard rehabilitation to enhance patients’ aerobic fitness and mobility after hip fracture surgery.