Pilot study on a new intervention programme for geriatric hip fracture patient with sarcopenia

Abstract

Introduction: Sarcopenia and osteoporosis increase the risk of fall, resulting in fragility fracture. Intervention programme on sarcopenic hip fracture was set up in our centre. Method: All patients aged ≥65 admitted to Caritas Medical Centre with operatively treated hip fracture and diagnosed with sarcopenia were included. Interventions include inpatient nursing education, dietary advice, therapist assessment and structured 12-week Geriatric Day Hospital (GDH) exercise programme. Those who are not eligible for GDH training were classified as control group. Changes in relative skeletal muscle mass index (RASM), muscle strength and functional scores were measured. Results: There were 11 intervention and 13 control patients. Both groups of patients were noted to have improvement in RASM, knee extension power of lower limbs and functional scores. Between-group analysis showed there was more improvement in injured limb extension power in the intervention group, although it is statistically insignificant (control group: 3.585 kg, intervention group: 5.827 kg, p = 0.147). There was no statistically significant difference in the 3-month change in RASM (control group: 0.581 kg/m2, intervention group: 0.347 kg/m2, p = 0.369) and functional scores. Conclusion: These sarcopenic hip fracture patients may be too frail to benefit from traditional exercise treatment for sarcopenia. However, more improvement in muscle strength was observed in the intervention group although not statistically significant. Intervention programme with exercise prescription in sarcopenic hip fracture patients may have the potential to improve the lower limb muscle strength. A more intensive and longer exercise training programme with incorporation into day rehabilitation model may be needed for these frail hip fracture patients.