Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effect of Rehabilitation With Versus Without Progressive Strength Training Implemented in the Acute Ward After Hip Fracture Surgery: A Randomized Controlled Trial
Brief Summary: The purpose of this study is to examine the effect of progressive strength training of the fractured limb in patients with hip fracture, during admittance in an acute orthopedic ward. The primary study hypothesis is that the training will reduce the strength deficit in the fractured limb in comparison with the non-fractured limb. Secondary, that patients following the intervention will present larger improvements in physical function compared to controls.


Options:
A: Inclusion Criteria:

* Have a primary diagnosis of hip fracture;
* Aged 60 years and above;
* Have functional limitation (i.e., as determined by limitation in at least one of 9 functional tasks listed in the SF-36 physical function scale, excluding vigorous activities);
* Have recently been discharged from rehabilitation services;
* Be able to understand and communicate in English;
* Be able to safely and independently stand with or without the aid of a mobility device, without needing any assistance or supervision from another person;
* Have received written clearance from their primary care physician documenting no contra-indications for participating in the study;
* Be able to provide written informed consent.

Exclusion Criteria:

* Have serious cognitive deficits (i.e., a Mini-Mental State Examination score of less than 20)85;
* Have severe depression (i.e., a score of 20 or greater on the Geriatric Depression Scale)86;
* Have a terminal illness with survival expected to be less than 1 year;
* Have significant pulmonary or cardiovascular contraindications or pre-existing conditions that preclude participating in an exercise program;
* Legally blind;
* Currently receiving rehabilitation therapy;
* Live outside of the study's catchment area in the Boston metropolitan area and eastern Massachusetts.
B: Inclusion Criteria:

* Primary hip fracture surgery
* 65 years or older
* Speak and understand the Danish language
* Able to give informed consent
* Home-dwelling with and independent prefracture indoor walking ability equal to New Mobility Score \>=2

Exclusion Criteria:

* Multiple fractures
* Weightbearing restrictions
* Patient unwilling to participate in appropriate rehabilitation
* Not able to cooperate to tests
* Terminal illness
* Patients who want an observer present at the information interview, but where such one is not available.
* Patients with a cervical hip fracture treated with Total Hip Arthroplasty or hip pins, due to expected short length of hospital stay.
C: Inclusion Criteria:

* Closed fracture of proximal femur
* Age 60 or older at time of randomization
* Minimal trauma fracture
* Non-pathologic fracture
* Surgical fixation of fracture
* Living in the community at time of fracture
* Ambulating without human assistance 2 months prior to fracture
* Unable to walk 300 m or more in 6 minutes without human assistance at time of randomization

Exclusion Criteria:

* Not English speaking
* Does not live within reasonable distance of the clinical center
* End stage renal disease on dialysis
* Recent myocardial infarction
* Uncompensated congestive heart failure
* Lower extremity amputation
* Symptoms of angina pectoris
* Chest pain or shortness of breath (including from severe COPD)
* Participant plans to move out of area or otherwise be unavailable during the 16-week intervention period
* Participation in another clinical trial
* Not community-residing (e.g., resident of a skilled nursing facility) at time of randomization
* Not fully weight-bearing on fractured leg or non-fractured leg at time of randomization
* Calculated creatinine clearance \< 15 ml/min
* Serum albumin \< 2.5 g/dl
* Hemoglobin \< 9 g/dl
* Receiving physical therapy for the hip fracture in the hospital or inpatient rehabilitation facility at time of randomization
* Severely diminished lower extremity sensation or ulceration
* Uncontrolled hypertension
* Denied medical clearance by appropriate medical provider
* Clinical site clinician thinks participant is not a good candidate for study (e.g., not likely to survive study period)
* Cognitive impairment (3MS score \<73)
* Development of chest pain or substantial shortness of breath or ambulating with severe pain during baseline SMWT
* Participant walks less than 4 meters in 40 seconds (\<0.1 m/sec) during baseline SMWT
* Not randomized by 26 weeks post admission for hip fracture
* Final sign-off from study clinician and/or principal investigator is incomplete
* Incomplete baseline data
* Unable to contact participant
* Participant is unable to provide her/his own informed consent
* Participant refuses the study
D: Inclusion Criteria:

* Admission to The Alfred with an isolated hip fracture and treated with internal fixation, aged 65 or above

Exclusion Criteria:

* fracture is in the sub-trochanteric region of the femur,
* if it is pathological,
* if post operative orders are for non-weight bearing on the operated hip,
* if they were unable to mobilise independently (or with gait aid) prior to admission,
* or if they were admitted from a nursing home.

Answer: B