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DOS Kongressen 2016 ·
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Efficacy of 6 versus 12 weeks physiotherapy
including progressive strength training in patients
shortly after hip fracture surgery – a multicenter
randomized controlled trial.
Jan Arnholtz Overgaard, Thomas Kallemose, Morten Tange Kristensen
Dept. of Rehabilitation, Municipality of Lolland, Maribo; Physical Medicine
and Rehabilitation Research - Copenhagen (PMR-C); Dept. of Orthopaedic
Surgery, Clinical Research Centre, Copenhagen University Hospital Hvidovre;
Departments of Physiotherapy & Orthopaedic Surgery, Hvidovre Hospital,
Copenhagen University, Copenhagen; Physical Medicine and Rehabilitation
Research - Copenhagen (PMR-C)
Background:
The latest Cochrane review emphasized the need for RCTs to in-
vestigate the timing, duration, and intensity of different physiotherapy (PT) in-
terventions in patients with hip fracture (HF). However, such studies have most
often been conducted as extended programs following ceased standard PT.
Purpose / Aim of Study:
To examine if 12 weeks of community-based PT
with progressive strength training is more efficacious than 6 weeks in improving
walking distance in patients when commenced shortly after discharge from HF
surgery.
Materials and Methods:
100 community-dwelling patients with HF were in-
cluded from 4 outpatient centers at a mean (SD) of 18 (5.9) days after sur-
gery, and equally randomized in two groups, in this assessor blinded study. Both
groups received functional, balance, and progressive lower limb strength train-
ing exercises, 2 times a week. The primary outcome was change in walking dis-
tance in the 6-minute walk test from baseline to the 6 months follow-up.
Findings / Results:
Intention-to-treat analysis showed no significant be-
tween-group difference in the primary outcome, versus significant improve-
ments, mean of 3.5 (95%CI; 0.8 to 6.1) seconds for the TUG in favor of the 12-
week group. The fractured limb strength deficit % non-fractured was reduced
with a mean of 34% in the 12-week group as compared to 24% in the 6-week
group. Still, 46% of all patients had not regained their pre-fracture functional
level at follow- up.
Conclusions:
12 weeks of PT with strength training was not more efficacious
than 6 weeks in improving the walking distance in patients with HF, but a signifi-
cant improvement was seen for the Timed Up & Go test in favor of the 12-week
group. Also, the 12-week program seems superior in reducing the fractured
limb strength deficit. However, almost half of all patients still experienced func-
tional deficits after 6 months.
No conflicts of interest reported
108.