High Intensity Physiotherapy for Hip Fractures

NCT02088437 | Completed DMC

• 1 other identifier: 32/14
• Study Type: interventional
• Target: 92
• Locations: 1 country
• Sites: 1

Brief Summary

Every day, more than 40 Australian break their hip, Most are over the age of sixty five. Hip fractures are a significant problem for the older people, the hospital system and community as a whole because of the increasing numbers of fractures and the cost of hospitalisation and ongoing care. After one year, less than half of all people with a hip fracture can walk as well as they did before the fracture. Physiotherapy in the acute hospital setting is an integral part of patient care, although the intensity of physiotherapy a patient receives is variable and the optimal number of treatment sessions per day remains unknown. Studies in other patient groups have shown that increased physiotherapy can improve patient outcomes by increasing muscle strength and mobility. It can also reduce the negative effects of bed rest such as muscle wasting, blood clots in the lungs or leg veins and chest infections such as pneumonia. This study aims to investigate the effectiveness of an intensive physiotherapy program in hip fracture patients to further understand this and the effect it has on patient function. In this research the investigators will randomly allocate patients into 2 groups; usual care and intensive physiotherapy. The usual care group will have physiotherapy treatment daily whereas the intensive physiotherapy group will have an additional daily treatment by a physiotherapist as well as a daily treatment by an allied health assistant. The objectives are to achieve better functional outcomes in the patient's hospital stay (ie improved mobility), reduce the time for patients to be physically ready to go home, increase the number of patients able to go directly home or to fast stream rehabilitation (rather than a slow stream option). If increased intensity of physiotherapy is found to improve patient's mobility outcomes, this research will provide the confidence to endorse a change to current clinical practice.

Conditions

Hip Fractures

Outcome Measures

Primary Outcomes (1)

• modified IOWA Level of Assistance Scale

  Functional score measuring 6 mobility domains

  5 days

Secondary Outcomes (7)

• length of stay - acute and rehabilitation

  participants will be followed for duration of hospital stay - average one month

• timed up and go

  5 days

• Glasgow Outcomes Score -Extended

  6 months

• discharge destination

  participants will be followed until discharge from the acute hospital - average 10 days

• physical readiness for discharge

  average one month

Study Arms (2)

Usual care

ACTIVE COMPARATOR

usual care physiotherapy - once daily treatment whilst inpatient in acute hospital

Other: Usual Care

Intensive physiotherapy

EXPERIMENTAL

additional once daily physiotherapy and once daily allied health assistant intervention

Other: Intensive physiotherapy

Interventions

Intensive physiotherapy OTHER

additional once daily physiotherapy and once daily allied health assistant intervention (equals two more treatments) whilst an inpatient in acute hospital

Intensive physiotherapy

Usual Care OTHER

once daily physiotherapy whilst acute hospital inpatient

Usual care

Eligibility Criteria

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

You may qualify if:

• Admission to The Alfred with an isolated hip fracture and treated with internal fixation, aged 65 or above

You may not qualify if:

• fracture is in the sub-trochanteric region of the femur,
• if it is pathological,
• if post operative orders are for non-weight bearing on the operated hip,
• if they were unable to mobilise independently (or with gait aid) prior to admission,
• or if they were admitted from a nursing home.

Sponsors & Collaborators

• The Alfred: lead

Study Sites (1)

The Alfred

Melbourne, Victoria, 3181, Australia

Location

Related Publications (1)

• Kimmel LA, Liew SM, Sayer JM, Holland AE. HIP4Hips (High Intensity Physiotherapy for Hip fractures in the acute hospital setting): a randomised controlled trial. Med J Aust. 2016 Jul 18;205(2):73-8. doi: 10.5694/mja16.00091.

  PMID: 27456448 DERIVED

MeSH Terms

Conditions

Hip Fractures

Condition Hierarchy (Ancestors)

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

Study Officials

• Lara A Kimmel, B.Physio

  The Alfred

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: CARE PROVIDER, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: March 6, 2014
• First Posted: March 17, 2014
• Study Start: March 1, 2014
• Primary Completion: January 1, 2015
• Study Completion: September 1, 2015
• Last Updated: December 31, 2015

Record last verified: 2015-12

Locations

AU (1)