None listed
Conditions
Brief summary
Hip fracture is a common and serious fracture affecting older Australians, with high risk of ongoing disability. After hip fracture many people have very low levels of physical activity. There is evidence that increasing physical activity has many health benefits, but this is challenging for people after hip fracture due to pain, fatigue, psychological factors and co-morbidities. Preliminary studies from our team have investigated the amount of physical activity that people can tolerate after hip fracture without adverse effects. In the community, we determined that people after hip fracture could safely and feasibly complete 100 minutes of moderate intensity walking in a week. This proposed randomised controlled trial will determine whether prescribing this amount of physical activity (100 min/week) in addition to usual care is a feasible and effective intervention for improving health outcomes in this patient group. It is hypothesised that completing 100 min/week of prescribed walking is feasible for people recovering from hip fracture and effective in improving functional independence.
Interventions
In addition to usual care, participants in the intervention group will be prescribed 100 minutes of walking per week, of at least moderate intensity, in bouts of at least 10 minutes. Moderate level of intensity will be determined by the Rate of Perceived Exertion Scale (0 to 10) where level 3 - “I am still comfortable but am breathing a little harder”. The weekly composition of the 100 minutes of walking will be decided in consultation between the participant and the allied health clinician at
In addition to usual care, participants in the intervention group will be prescribed 100 minutes of walking per week, of at least moderate intensity, in bouts of at least 10 minutes. Moderate level of intensity will be determined by the Rate of Perceived Exertion Scale (0 to 10) where level 3 - “I am still comfortable but am breathing a little harder”. The weekly composition of the 100 minutes of walking will be decided in consultation between the participant and the allied health clinician at the planning session (e.g. 5 x 20 min, 6 x 15 min + 1 x 10 min). The walking doses will be completed in the community using normal assistive devices, such as a walking stick if required. The weekly dose will be completed for 12 weeks in the community. To increase adherence to the intervention and maximise the effectiveness of the intervention, we will use the following behavioural change techniques and strategies: - Planning session with goal setting – an allied health clinician will assist the participant to determine when and where to complete the dose of walking; - Supervision - allied health clinician supervision of one session of walking weekly; - Monitoring - each participant will wear a pedometer provided by the study to self-monitor the number of steps each week when completing their prescribed walking. The allied health clinician will also monitor pain levels at each supervised session using a visual analogue scale. They will also complete a logbook to record the number of steps and time spent walking each week; - Engaging social supports - each participant will be encouraged to walk with a friend, family member, or other support person.
Sponsors
Eastern Health
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Participants will be included if they: • had a hip fracture (S72.0–S72.2 according to the International Classification of Diseases 10th revision, ICD-10) which was managed surgically, • are aged 60 years or older, • are community-dwelling and receiving services from the Community Rehabilitation Program at Eastern Health • are able to walk independently with or without a gait aid, • can communicate with conversational English. Participants will not be excluded on the basis of cognitive impairment. However, if the potential participant scores more than four errors on the 10-item Short Portable Mental Status Questionnaire (indicating more than mild intellectual impairment) then informed consent will be sought from a carer or responsible person. In this case the researcher will explain to the participant, as far as possible, what the research is about and what participation involves.
Exclusion criteria
Participants will be excluded if they: • have been discharged to live in residential care, • exceed the physical activity guidelines of at least 150 minutes of moderate to vigorous physical activity
Outcome results
None listed