None listed
Conditions
Brief summary
Every year more than 22,000 Australians break their hip, costing hospitals $579 million and requiring more than 579,000 hospital bed days. Only 24% of patients regain their usual walking capacity after 4 months. Previous research showed patients receiving higher intensity physiotherapy regained their physical capacity more quickly and spent fewer days in hospital than those receiving regular physiotherapy care. In this trial we will test whether the intervention can deliver the same benefits at a range of Australian hospitals. This randomised controlled trial will take place across 8 acute hospitals, recruiting 620 participants. Participants allocated to the intervention group will receive intensive physiotherapy, delivered 3 times/day for 7 days following surgery. Those allocated to usual care will receive what is usually provided at that site. The primary aim is total hospital length of stay. Secondary aims include costing and patient reported outcome measures over 12 months post hip fracture surgery.
Interventions
Participants in the intervention group will receive usual care physiotherapy as per the control treatment, plus two additional daily sessions. One session will be delivered by an allied health assistant, to practice the achievements of the usual care session. The other session will be delivered by a physiotherapist and targeted to the needs of the patient with the aim of progressing the functional gains achieved in the previous therapy session including increasing independence with mobility, pro
Participants in the intervention group will receive usual care physiotherapy as per the control treatment, plus two additional daily sessions. One session will be delivered by an allied health assistant, to practice the achievements of the usual care session. The other session will be delivered by a physiotherapist and targeted to the needs of the patient with the aim of progressing the functional gains achieved in the previous therapy session including increasing independence with mobility, progression of gait aid (e.g. frame to crutches) and increasing the distance walked. We anticipate that the sessions will be approximately 30 minutes each although will be targeted to the patient and their ability to participate. The sessions will be at least 2 hours apart to allow time for the patient to rest in between sessions. The intervention will be delivered for 7 days or until discharge from the acute ward, whichever occurs sooner. The occasions of service and length of each treatment session will be recorded to monitor adherence to the intervention. Participants in the intervention group will also receive medical and surgical management according to best practice standards. Allied health interventions aside from physiotherapy (e.g. occupational therapy) will be delivered according to usual practice at each centre with all encounters recorded.
Sponsors
Monash University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Aged 65 years or older and admitted with an isolated subcapital or intertrochanteric hip fracture subsequently managed operatively
Exclusion criteria
Patients will be excluded if the fracture is subtrochanteric or pathological, if the postoperative orders require non-weightbearing on the operative hip, if unable to mobilise (with or without a gait aid) prior to fracture, or if living in nursing home or aged care facility.
Outcome results
None listed