Effectiveness of a physical exercise intervention program in improving functional mobility in older adults after hip fracture in late stage rehabilitation: a randomized clinical trial

Abstract

Hip fractures resulting from falls increase substantially with advancing age and less than a half of the elderly that have sustained and survived after the surgery regain their former levels of mobility. There is increasing evidence that rehabilitation interventions involving exercises and extended beyond the sub acute phase or even in a later stage of care have a positive impact on various functional abilities. The purpose of this study is to determine if an exercise program training for people who have suffered a fall-related hip fracture will improve functional mobility when compared with usual care. Design: Randomized controlled trial using blinded assessors and intention-to-treat analysis. Participants: We will recruit 220 older adults, 60 years or over who have suffered a hip fracture due to a fall and have or have not completed physiotherapy and/or rehabilitation. These participants will be in a later stage rehabilitation phase (6 months up to 2 years after the fracture). Intervention: Participants randomized to the Intervention Group (IG) will be submitted to a physical exercise program involving a progressive and challenging balance training and a neuromuscular and functional training of the lower limbs, conducted in an outpatient facility during 12 weeks, twice a week, plus home-based exercises conducted at least once a week during the intervention phase and three times weekly after the complention of the intervention for 12 months. The control group will receive usual care. Outcomes: The primary outcome will be mobility-related disability and participants will be assessed in the baseline, at the end of the intervention (3 months), at 6 and 12 months. The participants will receive monthly phone calls to investigate falls and exercise adherence. Adverse effects will be monitored. (AU)