The Stronger at Home Study
Condition: Hip Fractures
MeSH terms: Hip Fractures
Study type: Interventional

Summary: 
      Hip fracture is a major health problem facing older adults. Hip fractures result in higher
      mortality, morbidity, and costs than all other osteoporotic fractures combined. When
      returning home following hip fracture surgery, patients are at high risk of adverse outcomes
      (e.g., secondary fractures, institutionalisation, and death).

      Objectives: This study aims to finalize and pilot test a new program of care including a
      user-friendly toolkit containing a home-based physiotherapy exercise and pain management
      program to help community-dwelling older adults recover after hip fractures.

      Methods: This study will be two stages: First, finalizing the program. The investigators have
      created a self-explanatory toolkit that includes an illustrated exercise program based on a
      critical analysis of previous programs for hip fracture patients. The investigators will
      organize focus groups and conduct semi-structured interviews with patients, caregivers,
      policymakers, and healthcare providers to review the program and provide feedback.

      Second, conducting a feasibility study. The investigators will pilot the program in a
      randomized trial with community-dwelling hip fracture patients and compare the intervention
      with conventional care.

      Expected Outcomes: While the number of hip fracture survivors is increasing, they are
      becoming frailer, and their functional recovery has not improved, making this study timely
      and relevant. With the current focus on helping older adults "age in place," the proposed
      project addresses a vital health system challenge: helping older hip fracture patients access
      proper rehabilitation, so they can stay independent in their homes.
    


Intervention name(s): Rehabilitation Program; Pain self management; Conventional care
Intervention type(s): Other; Other; Other
Intervention description(s): PT visits (two visits): The first visit will happen within a week of discharge. During this visit, the PT will assess participants, tailor the program to their needs, and coach them in carrying out the exercises at home. The last visit will be 12 weeks after the first. During this visit, the PT will reassess the participants and make adjustments to the program. The participants will be encouraged to continue exercising beyond the 12 weeks.
The PTA will visit the participants' homes with the PT and will conduct additional solo visits every other week (i.e. 7 PTA visits in total, in 1st week and at 2, 4, 6, 8, 10, and 12 weeks). The PTA will facilitate and progress the exercise program as prescribed and directed by the PT and help in delivering the education component of the program.; In addition to the exercise program, the intervention group will receive a pain self-management support tailored by the PT to the participants' needs.; The control group will receive the usual care provided by the healthcare system.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment