Balance Rehabilitation After Hip Fracture Surgery

Study Overview
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Brief Summary
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The overall functional gain by balance rehabilitation after hip fracture surgery has not yet been fully investigated. Therefore, clinical studies should be conducted to evaluate the effectiveness of systematic and safe balance rehabilitation in patients after hip fracture. Investigators aim to evaluate the effect of computer-based balance specific exercise on the performance and balance ability of the elderly women who underwent hip fracture surgery. Investigators also investigate the intervention can reduce their fear of falling and coping ability. This study was designed as a prospective, open-label, single-center trial at a tertiary hospital setting. During the 2-week postoperative intervention period, patients will participate in the hospital's exercise program beginning 5-7 days after hip fracture surgery. All participants will follow the computer-based balance specific exercise program. Functional outcomes will be measure periodically for 6 months after surgery.

Official Title
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Effectiveness of the Computerized Balance Rehabilitation After Hip Fracture Surgery

Conditions
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Hip Fractures

Intervention / Treatment
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* Procedure: Balance specific exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Elderly female patients (≥ 65 years old) who have undergone surgery for femoral neck, intertrochanteric, or subtrochanteric fracture, regardless of surgery type (internal fixation, bipolar hemiarthroplasty, or total hip arthroplasty) Exclusion Criteria: 1) hip surgery for infection, arthritis, implant loosening, or avascular necrosis; 2) femoral shaft fracture, acetabular fracture, isolated fracture of the greater or lesser tuberosity, or periprosthetic fracture; 3) pathologic fracture; 4) combined multiple fracture; 5) revision surgery; 6) severe cognitive dysfunction (obey command ≤ 1 step); 7) cannot stand by supporting a fixed walker at 5 days after operation; 8) patients who refuse to participate in a clinical trial

Ages Eligible for Study
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Minimum Age: 65 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Balance exercise group<br>During the 2-week postoperative intervention period, patients will participate in the hospital's exercise program beginning 5-7 days after HFS. All participants will follow the computer-based balance specific exercise (BSE) program. | Procedure: Balance specific exercise<br>* Balance specific exercise consists of total 10 days' physical therapy (PT) sessions (twice per day for 60 min) after surgery. It will be conducted with a computed posturographic system for diagnostics of balance and movement skills (Balance Master® System NeuroCom®) designed to objectively quantify balance and postural function of different origin. PT (weight-bearing, strengthening, gait training, aerobic, and functional exercises) was gradually increased based on the patient's functional level. Intensive patient education by multidisciplinary rehabilitation members was also provided.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of Berg balance scale | Berg balance scale (total score; 0 to 56) | Change from Baseline Berg balance scale at 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional Ambulatory Category | Functional Ambulatory Category (categorical score; 0 to 5) | Before intervention, After 2 weeks' intervention, 3 and 6 months after surgery | 
| Functional Independence Measure: locomotion | Functional Independence Measure (subscale of locomotion: 1 to 7) | Before intervention, After 2 weeks' intervention, 3 and 6 months after surgery | 
| Modified falls efficacy scale | Modified falls efficacy scale (total score: 0 to 140) | Before intervention, After 2 weeks' intervention, 3 and 6 months after surgery | 
| Presence of Fear of falling | Fear of falling (yes or no; by simple question Are you afraid of falling?) | Before intervention, After 2 weeks' intervention, 3 and 6 months after surgery | 
| Modified Barthel index | Modified Barthel index (tota; score: 0 to 100) | Before intervention, After 2 weeks' intervention, 3 and 6 months after surgery | 
| Short physical performance scale | Short physical performance scale (total score: 0 to 12) | Before intervention, After 2 weeks' intervention, 3 and 6 months after surgery |