Hip Fractures
Conditions
Keywords
Rehabilitation, cross-sectorial cooperation, older
Brief summary
Despite implementing hospital quality programs after hip fracture surgery older adults often experience a decline in the level of physical function, reduced quality of life; and the mortality and readmission rates are high. Early mobilization is important in order to prevent loss of muscle mass; however to prevent morbidity an early start of strength training is also necessary. Furthermore, the risk of complications, morbidity, and mortality are associated with insufficient management of pain. The project aims to examine the effect of measuring vital signs and consistent rehabilitation in the primary and secondary sectors in older adults after hip fracture surgery. Method/ design: The study is a cluster-randomized stepped wedge study. Participants will be recruited among patients admitted to an orthogeriatric ward who are 65 years of age or older and citizens in one of six municipalities. Participants are also the health professionals in the orthogeriatric ward and the six municipalities. The six municipalities form six clusters, which are randomized, and every three-month one cluster cross from control to intervention. The study compares usual practice (control) to an intervention named 'Rehabilitation of Life'. An intervention best described as an empowerment-oriented cross-sectorial program including vital sign measurement and systematic progressive rehabilitation and combined with convenient access for collaboration among professionals. Primary outcomes: Timed Up and Go (TUG) measured 2 months after the time of operation. The investigators hypothesize that 'Rehabilitation of Life' for older adults with a hip fracture will result in a significant reduced TUG-score in comparison to a practice not offering 'Rehabilitation of Life'. And as the study is organised across two sectors, the Cumulated Ambulation Score (CAS) makes a second primary outcome. It is hypothesised that patients in the intervention group will achieve a significantly reduced TUG score compared to usual care.
Interventions
OTHER'Rehabilitation for Life'
An empowerment-oriented cross-sectorial program including vital sign measurement and systematic progressive rehabilitation combined with convenient access for collaboration among professionals.
OTHERUsual care and rehabilitation
The care and rehabilitation usual provided to patients after hip fracture surgery
Sponsors
Kolding Sygehus
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Investigator, Outcomes Assessor)
Intervention model description
A cluster-randomized stepped wedge study. A design that is initiated with a period without interventions followed by a form of cross-over, in which each cluster systematic cross from control to intervention.
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients with a hip fracture * Patients of 65 years of age or older * Patients admitted to an orthogeriatric ward * Patient who are citizens in one og three municipalities
Exclusion criteria
* Patients discharged for permanent residence in nursing homes * Patients who cannot participate in a conversation * Terminal registered patients.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Timed up and go | Two months after the time of operation | Measures functional mobility, as the time in seconds it takes a person to rise from a chair with arms, walk 3 m and return to the chair. A higher scores mean a worse outcome |
| Cumulated Ambulation Score (CAS) | One months after the time of operation | Measures basic mobility. The score 0-6. Higher scores mean a better outcome |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Timed up and go | Three and six months after the time of operation | Measures functional mobility, as the time in seconds it takes a person to rise from a chair with arms, walk 3 m and return to the chair. A higher scores mean a worse outcome |
| Barthel-20 | 2, 3, 6 and 12 months after the time of surgery | A validated tool used to assess the patient's need for help to perform acitivities of daily living |
Other
| Measure | Time frame | Description |
|---|---|---|
| Mortality 30 days and 1 year. | Mortality measured after 30 days and one year | Mortality |
| Readmission | Readmission measured 30 days after discharge | Readmission rate |
| Eq-5D | 2, 3, 6 and 12 months after the time of surgery | A standardised questionnaire used to assess the patients health-related quality of life and function |
Countries
Denmark
Outcome results
None listed