Strength Training After Hip Fracture Surgery

Study Overview
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Brief Summary
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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.

Official Title
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Effect of Rehabilitation With Versus Without Progressive Strength Training Implemented in the Acute Ward After Hip Fracture Surgery: A Randomized Controlled Trial

Conditions
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Hip Fracture

Intervention / Treatment
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* Other: Rehabilitation with strength training
* Other: Rehabilitation without strength training


Participation Criteria
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Eligibility Criteria
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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.

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 |
| --- | --- |
| Active Comparator: Rehabilitation without strength training<br>Basic mobility and exercise therapy without strength training following a guideline with 12 specific exercises, progressed individually. | Other: Rehabilitation without strength training<br>* Basic mobility and exercise therapy without strength training following a guideline with 12 specific exercises, progressed individually.<br>|
| Experimental: Rehabilitation with strength training<br>Basic mobility and exercise therapy following a guideline with 12 specific exercises, progressed individually, and supplemented with progressive knee-extension strength training (10RM) of fractured limb every day during admission. | Other: Rehabilitation with strength training<br>* Basic mobility and exercise therapy following a guideline with 12 specific exercises, progressed individually, and supplemented with progressive knee-extension strength training (10RM) of the fractured limb using ankle weight cuffs, daily during hospital stay.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Knee-extension strength in the fractured limb in comparison with the non-fractured limb. | Maximal isometric knee-extension strength in the fractured limb in percentage of non-fractured limb. Isometric knee-extension strength will be measured using an externally fixated handheld dynamometer (Power Track II Commander; JTech Medical, Utah). A stap will be attached to the bed/chair and the patient's ankle (perpendicular to the lower leg), ensuring 90 degrees of knee flexion and an isometric contraction. The transducer will be placed under the strap at ankle level, just proximal to the malleolus, and the participant will be asked to extend the leg as forcefully as possible. Knee-extension strength will be expressed as the maximal voluntary torque per kilo body mass ([NIm]/kg), using the distance between the lateral femoral epicondyle and the center of the transducer and the body mass of each patient. The best of 4 trials for each limb will be used in analyses. The primary analysis will follow the intention-to-treat principle (last observation carried forward). | At inclusion, at postoperative day 10 and/or at discharge. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Timed up and go test | Timed Up and Go test is assessed as early as possible during in-hospital stay and at discharge. | From inclusion to postoperative day 10 and/or discharge | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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strength deficit, physical function