Clinical trial NCT02088437: High Intensity Physiotherapy for Hip Fractures
Official title: High Intensity Physiotherapy for Hip Fractures in the Acute Hospital Setting
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Hip Fractures
Lead sponsor: The Alfred
Sponsor class: OTHER
First posted: 2014-03-17
Enrollment: 92
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Every day, more than 40 Australian break their hip, Most are over the age of sixty five. Hip fractures are a significant problem for the older people, the hospital system and community as a whole because of the increasing numbers of fractures and the cost of hospitalisation and ongoing care. After one year, less than half of all people with a hip fracture can walk as well as they did before the fracture. Physiotherapy in the acute hospital setting is an integral part of patient care, although the intensity of physiotherapy a patient receives is variable and the optimal number of treatment sessions per day remains unknown. Studies in other patient groups have shown that increased physiotherapy can improve patient outcomes by increasing muscle strength and mobility. It can also reduce the negative effects of bed rest such as muscle wasting, blood clots in the lungs or leg veins and chest infections such as pneumonia. This study aims to investigate the effectiveness of an intensive physiotherapy program in hip fracture patients to further understand this and the effect it has on patient function.

In this research the investigators will randomly allocate patients into 2 groups; usual care and intensive physiotherapy. The usual care group will have physiotherapy treatment daily whereas the intensive physiotherapy group will have an additional daily treatment by a physiotherapist as well as a daily treatment by an allied health assistant. The objectives are to achieve better functional outcomes in the patient's hospital stay (ie improved mobility), reduce the time for patients to be physically ready to go home, increase the number of patients able to go directly home or to fast stream rehabilitation (rather than a slow stream option).

If increased intensity of physiotherapy is found to improve patient's mobility outcomes, this research will provide the confidence to endorse a change to current clinical practice.


Eligibility criteria: Inclusion Criteria:

* Admission to The Alfred with an isolated hip fracture and treated with internal fixation, aged 65 or above

Exclusion Criteria:

* fracture is in the sub-trochanteric region of the femur,
* if it is pathological,
* if post operative orders are for non-weight bearing on the operated hip,
* if they were unable to mobilise independently (or with gait aid) prior to admission,
* or if they were admitted from a nursing home.

Primary outcomes:
measure: modified IOWA Level of Assistance Scale
timeFrame: 5 days
Secondary outcomes:
measure: length of stay - acute and rehabilitation
timeFrame: participants will be followed for duration of hospital stay - average one month
measure: timed up and go
timeFrame: 5 days
measure: Glasgow Outcomes Score -Extended
timeFrame: 6 months
measure: discharge destination
timeFrame: participants will be followed until discharge from the acute hospital - average 10 days
measure: physical readiness for discharge
timeFrame: average one month
measure: 12-Item Short Form Health Survey (SF-12)
timeFrame: 6 months
measure: EuroQOL five dimensions questionnaire (EQ-5D)
timeFrame: 6 months
Other outcomes:
Locations:
city: Melbourne
country: Australia
facility: The Alfred
state: Victoria
Study officials:
affiliation: The Alfred
name: Lara A Kimmel, B.Physio
role: PRINCIPAL_INVESTIGATOR
References:
citation: Kimmel LA, Liew SM, Sayer JM, Holland AE. HIP4Hips (High Intensity Physiotherapy for Hip fractures in the acute hospital setting): a randomised controlled trial. Med J Aust. 2016 Jul 18;205(2):73-8. doi: 10.5694/mja16.00091.