Hip Fractures
Conditions
Keywords
Proximal hip fracture, Elderly patients, Physiotherapy, Leg cycling ergometer
Brief summary
This study aims to evaluate whether a combination of cycling training as part of physiotherapy treatment will contribute more than conventional physiotherapy treatment for elderly patients after hip fracture surgery in their subacute phase of rehabilitation.
Detailed description
Adults who have experienced a fall, followed by proximal hip fracture that required surgery, suffer from specific problems that interrupt the rehabilitation period in their subacute phase. Various modes of treatment available as part of the physical rehabilitation but there is not enough data in the literature regarding the contribution of cycling training with leg cycle ergometer as part of conventional physiotherapy treatment in elderly patients after hip fracture surgery. This study evaluates whether the additional cycling to physiotherapy treatment will improve the functional ability, the balance performance while standing, hip muscle strength and pain level in those patients.
Interventions
OTHERPhysiotherapy treatment & leg cycling
All patients receive comprehensive care as part of routine rehabilitation program : individual physical therapy treatment, gym's training and balance training in virtual reality, occupational therapy treatment, strengthening and range of motion exercises as a group. In addition each patient in this group will train with stationary leg cycle ergometer for 20 minutes under physical therapist's supervision . Cycling exercise intensity subjectively determined by the patient using RPE Borg scale . Maximal intensity level determined as 14 in Borg scale.
OTHERPhysiotherapy treatment & music listening
All patients receive comprehensive care as part of routine rehabilitation program : individual physical therapy treatment, gym's training and balance training in virtual reality, occupational therapy treatment, strengthening and range of motion exercises as a group. In addition each patient in this group will listen to music with earphone for 20 minutes while sitting under physical therapist supervision. Overall treatment session will last 50 minutes.
Sponsors
Beit-Rivka Geriatric Rehabilitation Hospital
Rabin Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
65 Years to 95 Years
Healthy volunteers
No
Inclusion criteria
* Proximal hip fracture with full or partial weight bearing indication. * Surgical fixation ( nailing or total hip replacement or hemiarthroplasty) * Pre-morbid function: walking independently or under supervision with or without assistance aid * Cognitive function: Mini-mental state examination score above 21
Exclusion criteria
* Pathological hip fracture. * Unstable heart or pulmonary disease. * Presence of other fractures as a result of the current fall. * Neurological comorbidities ( CVA, Parkinson, MS ). * Entering the rehabilitation center more than three weeks after hip surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| FIM ( functional independence measure) | baseline-at the first day of intervention | Provides a uniform system of measurement for disability, it measures the level of patient's disability and indicates how much assistance is required for the individual to carry out activities of daily living. It contains 18 items composed of 13 motor tasks and 5 cognitive tasks. Tasks are rated on 7 point ordinal scale that ranges from total assistance to complete independence. Score range from 18 (lowest) to 126 (highest) indicating level of function. |
| Static balance test and weight bearing distribution while standing | baseline-at the first day of intervention | The balance and weight bearing distribution parameters will be evaluated by posturographic device . This system assesses pressure fluctuations produced by the heels and toes of a subject standing on four separate platforms two for each foot and their respective halves. The pressure plates emit electronic signals which are digitized and processed by the posturographic device software to yield a set of unique parameters. Calculated results based on these parameters, which are statistically and functionally independent, reflect the interactions of the various neuro-physiological and neuro-anatomic subsystems involved in balance control. |
| Muscle strength | baseline-at the first day of intervention | Quadriceps strength and hand grip will be assessed by hand held dynamometer. This is a quantitative and objective method for assessment of muscular strength. Scored using force production in kilograms. |
| Pain intensity (measured with VAS) | baseline-at the first day of intervention | Subjective pain intensity will be measured with VAS which is an 11 point scale from 0-10, 0 indicates no pain and 10 indicates the most intense pain imaginable. The patient select the value that is most in line with the intensity of pain that he experienced in the last 24 hours. |
| Change from baseline in FIM at 2 weeks | Second week of intervention | Provides a uniform system of measurement for disability, it measures the level of patient's disability and indicates how much assistance is required for the individual to carry out activities of daily living. It contains 18 items composed of 13 motor tasks and 5 cognitive tasks. Tasks are rated on 7 point ordinal scale that ranges from total assistance to complete independence. Score range from 18 (lowest) to 126 (highest) indicating level of function. |
| Change from baseline in FIM at 3 weeks | End of intervention at third week | Provides a uniform system of measurement for disability, it measures the level of patient's disability and indicates how much assistance is required for the individual to carry out activities of daily living. It contains 18 items composed of 13 motor tasks and 5 cognitive tasks. Tasks are rated on 7 point ordinal scale that ranges from total assistance to complete independence. Score range from 18 (lowest) to 126 (highest) indicating level of function. |
| Change from baseline in muscle strength at 2 weeks | Second week of intervention | Quadriceps strength and hand grip will be assessed by hand held dynamometer. This is a quantitative and objective method for assessment of muscular strength. Scored using force production in kilograms. |
| Change from baseline in static balance test and weight bearing distribution while standing at 2 weeks | Second week of intervention | The balance and weight bearing distribution parameters will be evaluated by posturographic device . This system assesses pressure fluctuations produced by the heels and toes of a subject standing on four separate platforms two for each foot and their respective halves. The pressure plates emit electronic signals which are digitized and processed by the posturographic device software to yield a set of unique parameters. Calculated results based on these parameters, which are statistically and functionally independent, reflect the interactions of the various neuro-physiological and neuro-anatomic subsystems involved in balance control. |
| Change from baseline in static balance test and weight bearing distribution while standing at 3 weeks | End of intervention at third week | The balance and weight bearing distribution parameters will be evaluated by posturographic device . This system assesses pressure fluctuations produced by the heels and toes of a subject standing on four separate platforms two for each foot and their respective halves. The pressure plates emit electronic signals which are digitized and processed by the posturographic device software to yield a set of unique parameters. Calculated results based on these parameters, which are statistically and functionally independent, reflect the interactions of the various neuro-physiological and neuro-anatomic subsystems involved in balance control. |
| Change from baseline in muscle strength at 3 weeks | End of intervention at third week | Quadriceps strength and hand grip will be assessed by hand held dynamometer. This is a quantitative and objective method for assessment of muscular strength. Scored using force production in kilograms. |
| Change from baseline in pain intensity at 2 weeks (measured with VAS) | Second week of intervention | Subjective pain intensity will be measured with VAS which is an 11 point scale from 0-10, 0 indicates no pain and 10 indicates the most intense pain imaginable. The patient select the value that is most in line with the intensity of pain that he experienced in the last 24 hours. |
| Change from baseline in pain intensity at 3 weeks (measured with VAS) | End of intervention at third week | Subjective pain intensity will be measured with VAS which is an 11 point scale from 0-10, 0 indicates no pain and 10 indicates the most intense pain imaginable. The patient select the value that is most in line with the intensity of pain that he experienced in the last 24 hours. |
Countries
Israel
Contacts
Primary ContactAvital Hershkovitz, MD-PhD
Backup ContactHila Dahan, BPT
Outcome results
None listed