Mobility training after hip fracture: a randomised controlled trial

OBJECTIVE: to compare the effects of two different exercise programmes after hip fracture.

DESIGN: assessor-blinded randomised controlled trial.

SETTING: hospital rehabilitation units, with continued intervention at home.

SUBJECTS: 160 people with surgical fixation for hip fracture transferred to inpatient rehabilitation.

METHOD: in addition to other rehabilitation strategies, the intervention group received a higher dose (60 min/day) exercise programme conducted whilst standing and the control group received a lower dose exercise programme (30 min/day) primarily conducted whilst seated/supine. The primary outcome measures were knee extensor muscle strength in the fractured leg and walking speed, measured at 4 and 16 weeks.

RESULTS: 150 participants (94% of those recruited) completed the trial. There were no differences between the groups for the two primary outcome measures. Post hoc analyses revealed increased walking speed among those in the higher dose, weight-bearing exercise group with cognitive impairment at 4 and 16 weeks.

CONCLUSIONS: there was no benefit (or harm) due to the higher dose, weight-bearing exercise programme with respect to the primary outcome measures. However, people with hip fracture and cognitive impairment gained greater benefit from the higher dose programme than from the lower dose programme.