'Rehabilitation for Life'

Study Overview
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Brief Summary
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Despite implementing hospital quality programs after hip fracture surgery older adults often experience a decline in the level of physical function, reduced quality of life; and the mortality and readmission rates are high. Early mobilization is important in order to prevent loss of muscle mass; however to prevent morbidity an early start of strength training is also necessary. Furthermore, the risk of complications, morbidity, and mortality are associated with insufficient management of pain. The project aims to examine the effect of measuring vital signs and consistent rehabilitation in the primary and secondary sectors in older adults after hip fracture surgery. Method/ design: The study is a cluster-randomized stepped wedge study. Participants will be recruited among patients admitted to an orthogeriatric ward who are 65 years of age or older and citizens in one of three municipalities. Participants are also the health professionals in the orthogeriatric ward and the three municipalities. The three municipalities form five clusters, which are randomized, and every three-month one cluster cross from control to intervention. The study compares usual practice (control) to an intervention named 'Rehabilitation of Life'. An intervention best described as an empowerment-oriented cross-sectorial program including vital sign measurement and systematic progressive rehabilitation and combined with convenient access for collaboration among professionals. Primary outcome: Timed Up and Go (TUG) measured 2 months after the time of operation. The investigators hypothesize that 'Rehabilitation of Life' for older adults with a hip fracture will result in a significant reduced TUG-score in comparison to a practice not offering 'Rehabilitation of Life'

Official Title
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Effect of Measuring Vital Signs and Coherent Rehabilitation in Primary and Secondary Sectors in Older Adults After Hip Fracture Surgery

Conditions
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Hip Fractures

Intervention / Treatment
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* Other: 'Rehabilitation for Life'
* Other: Usual care and rehabilitation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with a hip fracture Patients of 65 years of age or older Patients admitted to an orthogeriatric ward Patient who are citizens in one og three municipalities Exclusion Criteria: Patients discharged for permanent residence in nursing homes Patients who cannot participate in a conversation Terminal registered patients.

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: Health Services Research
Allocation: Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: A cluster-randomized stepped wedge study. A design that is initiated with a period without interventions followed by a form of cross-over, in which each cluster systematic cross from control to intervention.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 'Rehabilitation for Life'<br>Vital sign measurement and rehabilitation | Other: 'Rehabilitation for Life'<br>* An empowerment-oriented cross-sectorial program including vital sign measurement and systematic progressive rehabilitation combined with convenient access for collaboration among professionals.<br>|
| Active Comparator: Usual care and rehabilitation<br>Usual care and rehabilitation provided in primary and secondary sectors | Other: Usual care and rehabilitation<br>* The care and rehabilitation usual provided to patients after hip fracture surgery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Timed up and go | Measures functional mobility, as the time in seconds it takes a person to rise from a chair with arms, walk 3 m and return to the chair. A higher scores mean a worse outcome | Two months after the time of operation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cumulated Ambulation Score (CAS) | Measures basic mobility. The score 0-6. Higher scores mean a better outcome | One months after the time of operation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Rehabilitation, cross-sectorial cooperation, older