Effect of Leg Strengthening Exercise After Hip Fracture

Study Overview
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Brief Summary
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The purpose of this trial was to examine the effectiveness of a short-term leg strengthening exercise program compared to attention control on improving leg strength, walking speed and endurance, physical performance, and physical function one year after hip fracture.

Detailed Description
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Poor functional outcomes are reported for the majority of older adults who sustain a hip fracture. The ability of hip fracture patients to make sustained functional improvements above and beyond natural recovery is unknown. It has been shown that gym-based programs can help old adults regain function after hip fracture. It is unclear if these results could be translated into the home setting that lacks the gym-based equipment, or if improvement would be sustainable. This program compares high intensity strength training performed in the home twice weekly for 10 weeks to an attention placebo control in which participants receive sensory electrical stimulation to leg muscles.

Official Title
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Effect of Leg Strengthening Exercise After Hip Fracture

Conditions
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Hip Fractures

Intervention / Treatment
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* Other: progressive resistance exercise
* Other: TENS


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Successful fixation (partial or total hip replacement or open reduction internal fixation) of a hip fracture within the last 6 months Were 65 years of age or older, were living at home prior to the fracture, had a physician referral and were discharged from physical therapy. Exclusion Criteria: Medical history of unstable angina or uncompensated congestive heart failure, ongoing chemotherapy or renal dialysis, history of stroke with residual hemiplegia, Parkinson disease, absent sensation in the lower extremities due to sensory neuropathy, life expectancy of less than 6 months, and Folstein mental status scores < 20.

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

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
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Exercise<br>High intensity lower extremity exercise | Other: progressive resistance exercise<br>* lower extremity strengthening: 3 sets of 8 repetitions at the 8 repetition maximum (8RM)for the hip and knee extensors, hip abductors, plantarflexors twice weekly for 10 weeks.<br>* Other names: strengthening exercise;|
| Sham Comparator: Attention control<br>lower extremity TENS | Other: TENS<br>* Transcutaneous electrical nerve stimulation (TENS) to elicit sensory information (comfortable tingling) for 7 minutes to bilateral muscle groups including the gluteal muscles, quadriceps, and gastroc-soleus muscles. TENS administered twice weekly for 10 weeks.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| lower extremity force production |  | one year after hip fracture | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| six minute walk distance |  | one year post fracture | 
| free and fast gait speed |  | one year post fracture | 
| modified physical performance test |  | one year post fracture | 
| SF-36 physical function |  | one year post fracture | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hip Fracture, Exercise, Rehabilitation, Functional Performance