Strength Training After Hip Fracture Surgery

NCT00848913 | Completed DMC

• 1 other identifier: H-A-2007-0127 + 37036
• Study Type: interventional
• Target: 90
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to examine the effect of progressive strength training of the fractured limb in patients with hip fracture, during admittance in an acute orthopedic ward. The primary study hypothesis is that the training will reduce the strength deficit in the fractured limb in comparison with the non-fractured limb. Secondary, that patients following the intervention will present larger improvements in physical function compared to controls.

Conditions

Hip Fracture

Keywords

strength deficit; physical function

Outcome Measures

Primary Outcomes (1)

• Knee-extension strength in the fractured limb in comparison with the non-fractured limb.

  Maximal isometric knee-extension strength in the fractured limb in percentage of non-fractured limb. Isometric knee-extension strength will be measured using an externally fixated handheld dynamometer (Power Track II Commander; JTech Medical, Utah). A stap will be attached to the bed/chair and the patient's ankle (perpendicular to the lower leg), ensuring 90 degrees of knee flexion and an isometric contraction. The transducer will be placed under the strap at ankle level, just proximal to the malleolus, and the participant will be asked to extend the leg as forcefully as possible. Knee-extension strength will be expressed as the maximal voluntary torque per kilo body mass (\[NIm\]/kg), using the distance between the lateral femoral epicondyle and the center of the transducer and the body mass of each patient. The best of 4 trials for each limb will be used in analyses. The primary analysis will follow the intention-to-treat principle (last observation carried forward).

  At inclusion, at postoperative day 10 and/or at discharge.

Secondary Outcomes (1)

• Timed up and go test

  From inclusion to postoperative day 10 and/or discharge

Other Outcomes (4)

• 10 meter fast speed, Cumulated Ambulation Score.

  At discharge and during in-hospital stay.

• Short Falls Efficacy Scale-International (Short FES-I)

  At discharge

• Verbal Ranking Scale (VRS)

  During in-hospital stay.

Study Arms (2)

Rehabilitation without strength training

ACTIVE COMPARATOR

Basic mobility and exercise therapy without strength training following a guideline with 12 specific exercises, progressed individually.

Other: Rehabilitation without strength training

Rehabilitation with strength training

EXPERIMENTAL

Basic mobility and exercise therapy following a guideline with 12 specific exercises, progressed individually, and supplemented with progressive knee-extension strength training (10RM) of fractured limb every day during admission.

Other: Rehabilitation with strength training

Interventions

Rehabilitation with strength training OTHER

Basic mobility and exercise therapy following a guideline with 12 specific exercises, progressed individually, and supplemented with progressive knee-extension strength training (10RM) of the fractured limb using ankle weight cuffs, daily during hospital stay.

Rehabilitation with strength training

Rehabilitation without strength training OTHER

Basic mobility and exercise therapy without strength training following a guideline with 12 specific exercises, progressed individually.

Rehabilitation without strength training

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• Primary hip fracture surgery
• years or older
• Speak and understand the Danish language
• Able to give informed consent
• Home-dwelling with and independent prefracture indoor walking ability equal to New Mobility Score \>=2

You may not qualify if:

• Multiple fractures
• Weightbearing restrictions
• Patient unwilling to participate in appropriate rehabilitation
• Not able to cooperate to tests
• Terminal illness
• Patients who want an observer present at the information interview, but where such one is not available.
• Patients with a cervical hip fracture treated with Total Hip Arthroplasty or hip pins, due to expected short length of hospital stay.

Sponsors & Collaborators

• Hvidovre University Hospital: lead

Study Sites (1)

Department of Orthopedic Surgery hvidovre hospital

Hvidovre, Copenhagen, 2650, Denmark

Location

Related Publications (1)

• Kronborg L, Bandholm T, Palm H, Kehlet H, Kristensen MT. Effectiveness of acute in-hospital physiotherapy with knee-extension strength training in reducing strength deficits in patients with a hip fracture: A randomised controlled trial. PLoS One. 2017 Jun 29;12(6):e0179867. doi: 10.1371/journal.pone.0179867. eCollection 2017.

  PMID: 28662153 DERIVED

MeSH Terms

Conditions

Hip Fractures

Interventions

Rehabilitation; Resistance Training

Condition Hierarchy (Ancestors)

Femoral Fractures; Fractures, Bone; Wounds and Injuries; Hip Injuries; Leg Injuries

Intervention Hierarchy (Ancestors)

Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Health Services; Health Care Facilities Workforce and Services; Exercise Therapy; Physical Therapy Modalities; Physical Conditioning, Human; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Lise Kronborg, MSc

  PMR-C, Copenhagen University at Hvidovre Hospital.

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Seniorresearcher, PhD

Study Record Dates

• First Submitted: February 19, 2009
• First Posted: February 20, 2009
• Study Start: October 1, 2013
• Primary Completion: June 1, 2015
• Study Completion: June 1, 2015
• Last Updated: June 3, 2015

Record last verified: 2015-06

Locations

DK (1)