Clinical trial NCT04228068: The Stronger at Home Study
Official title: A Home-Based Rehabilitation Program for Patients With Hip Fracture: A Pilot Randomized Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Hip Fractures
Lead sponsor: Queen's University
Sponsor class: OTHER
First posted: 2020-01-14
Enrollment: 32
Sex: ALL
Minimum age (years): 65
Maximum age (years): 120
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief 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.


Eligibility criteria: Inclusion Criteria:

* hip fracture patients who are 65 years or older
* being discharged to home or retirement home .

Exclusion Criteria:

* participants with a terminal illness or significant contraindications preventing exercising (e.g. rapidly progressing neurological disease),
* live away more than 30 km from the centre of the city, and
* cannot sign the consent form and no proxy available to sign.

Primary outcomes:
measure: Change in the Lower Extremity Functional Scale (LEFS)
timeFrame: Change from baseline (before discharge) to 12 weeks post discharge to home (post intervention)
Secondary outcomes:
measure: The Short Physical Performance Battery (SPPB)
timeFrame: Change from baseline (before discharge), to 12 weeks weeks post discharge to home
Other outcomes:
Locations:
city: Kingston
country: Canada
facility: Providence Care Hospital
state: Ontario
Study officials:
References:
citation: Fairhall NJ, Dyer SM, Mak JC, Diong J, Kwok WS, Sherrington C. Interventions for improving mobility after hip fracture surgery in adults. Cochrane Database Syst Rev. 2022 Sep 7;9(9):CD001704. doi: 10.1002/14651858.CD001704.pub5.