The Centers for Disease Control and Prevention state that in 2010, there were 258,000 hospital admissions for hip fractures among Americans aged 65 and older. Although patients with hip fractures undergo standard rehabilitation, new research suggests that following this up with a home-based exercise program can further improve patients' recovery.
This is according to a study recently published online in the journal JAMA.
The research team, led by Nancy K. Latham of Boston University in Massachusetts, says that 2 years after a hip fracture, around 39% of women and over 50% of men have either passed away or are living in a long-term care facility.
"Many of these patients are no longer able to independently complete basic functional tasks that they could perform prior to the fracture, such as walking one block or climbing five steps 2 years after a fracture," the investigators write.
They note that it has not been established as to whether a home-based exercise program may improve the physical function of patients who have suffered a hip fracture.
Patients received home exercise program or nutrition advice
To find out, the research team analyzed 232 patients who had suffered a hip fracture and undergone standard rehabilitation.
Patients were randomized to one of two groups. The first group, made up of 120 patients, carried out a home exercise hip rehabilitation program. This was made up of exercises including standing on a chair and climbing a step.
All exercises were taught to patients by a physical therapist and patients were required to carry out the program in their homes for 6 months.
The second group, made up of 112 patients, received in-home and telephone-based cardiovascular nutrition education for 6 months.
The physical function of 195 patients was assessed at 6 months after the study baseline and again at 9 months. Of these patients, 100 were in the group that carried out the home exercise program, while 95 were in the nutrition education group.
Home exercise program 'improved physical function and balance'
The investigators found that the patients who carried out the home exercise hip rehabilitation program showed significant improvement in physical function and balance, compared with the group that received cardiovascular nutrition education.
The improvement in physical function for these patients could still be seen 9 months after study baseline.
Commenting on the findings, the researchers say:
"The traditional approach to rehabilitation for hip fracture leaves many patients with long-term functional limitations that could be reduced with extended rehabilitation."
Regardless of these findings, the research team says it is unlikely that patients who suffer hip fractures could receive extended supervised rehabilitation.
They point to the increasing costs of care, stating that outpatient therapy costs have increased by an average of 4% a year for the past decade.
However, the researchers say there may be alternative strategies, such as the use of outpatient physical therapy services.
"Outpatient physical therapy services are typically delivered in discrete short-term episodes and include a limited number of visits. After an episode is completed, the patient is discharged with a written home exercise program and instructions to carry out this program independently on an ongoing basis," the investigators explain.
"The findings from our study suggest that this approach could be introduced to patients after completion of traditional physical therapy following hip fracture and may provide a more effective way for these patients to continue to exercise in their own homes."
But the research team notes that further research is warranted to determine whether these interventions could be applied in a cost-effective manner.
Last year, Medical News Today reported on a study detailing how ongoing exercise programs could benefit older breast cancer survivors, while a recent study suggests that more intensive hospital exercise programs could help patients with dementia.
Written by Honor Whiteman