Home exercise programs may help hip fracture patients regain normal functional abilities more quickly, according to new research.
In a new study published in The Journal of the American Medical Association, researchers sought to create a home exercise program requiring minimal supervision for adults who had experienced a hip fracture. Typically, patients who suffer a hip fracture receive three or four days of rehabilitation at an acute care hospital before being sent to rehab or to a skilled nursing facility for a few weeks for care.
However, researchers said many patients require more care.
"It’s a major trauma, a lot of pain, and they’re left to go back home,” physical therapist Nancy K. Latham, a research assistant professor at the Health and Disability Research Institute at the Boston University School of Public Health told FoxNews.com. “The epidemiological data is so strong [and shows] that most of them never get close to where they were with walking and mobility before the fracture.”
More than 250,000 people in the U.S. fracture a hip every year – and long-term outcomes for hip fracture patients are discouraging. Two years after experiencing a hip fracture, more than 80 percent of patients who could previously walk without assistance and climb stairs are unable to resume these activities, Latham said. This immobility, combined with fear of falling, prevents them from doing any activities – often leading to a downward spiral in function and quality of life.
For their study, Latham and her team worked with 195 functionally-limited older adults who had completed traditional rehabilitation after a hip fracture. Half of the group received cardiovascular nutrition education, while the intervention group received instruction for home rehabilitation including three to four home visits with a physical therapist, training for exercises and goal-setting tools.
The exercises mimicked basic tasks participants would need to go about their everyday lives, such as repeatedly sitting in a chair and standing, standing up and reaching high and stepping up and down a step. Participants also worked with a goal calendar that included rewards to build confidence and encourage adherence to the plan.
“We’re not looking at people wanting to go back to being elite athletes. They just want to be able to get back to doing their daily activities in the same way they could, and managing themselves,” Latham said. “We knew if we took them to the gym, we could get stronger results, but that’s not the point.”
Physical therapists also used one of their visits to show participants a video addressing fears of falling – a common psychological side effect of a hip fracture.
“People experience a huge loss of self-confidence over [a hip fracture] that can start a spiral of inactivity where people become very fearful of moving,” Latham said.
After six months, the intervention group had significant improvement in functional mobility and balance, over the control group. Three months after the study ended, researchers followed up with participants and the intervention group continued to have better functionality. Researchers hope their findings will change the way health care professionals looks at home exercise and rehabilitation programs.
“The average age [of our participant] was 78 or 79; many of them have more than a decade of life or more left. It’s so worth investing in these people,” Latham said. “We didn’t study the cost [of our program], but the cost of moving someone to long-term care is enormous for the system.”