AIMS Medical Science, 2018, 5(3): 268-283. doi: 10.3934/medsci.2018.3.268

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Recovery of physical function after hip fracture: Analysis of secondary outcomes from a randomized controlled trial

1 The University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada
2 Centre for Hip Health and Mobility, 7F-2635 Laurel Street, Vancouver, BC V5Z 1M9, Canada
3 Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, 454-6 -753 McDermot Avenue, Winnipeg, MB R3E0T6, Canada
4 Division of Geriatric Medicine, UBC Department of Medicine, 7th floor, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
5 Providence Healthcare, 9B-St. Paul’s Hospital, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada
6 UBC Department of Orthopaedics, 3114-910 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada
7 Centre for Clinical Epidemiology and Evaluation, 7th Floor, 828 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada
8 Centre for Health Evaluation & Outcome Sciences, 588-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada
9 Department of Family Practice, The University of British Columbia (UBC), 320-5950 University Boulevard, Vancouver, BC V6T 1Z3, Canada

Purpose: To evaluate the effect of comprehensive geriatric management on physical function after hip fracture. Materials and methods: This was a parallel-group 1:1 single-blinded randomized controlled trial. Fifty-three older adults (≥ 65 years) 3 to 12 months after hip fracture were randomized through a web-based system (independent statistical company) into usual care or usual care plus intervention (B4). The B4 group received management by a geriatrician, physical therapist and other health professionals. Outcomes were: Leg (knee extension) and grip strength, timed up and go; and self-report function at baseline, 6 and 12 months (blinded assessment). We estimated between-group differences at 6 and 12 months using linear mixed models, and compared function between groups with a global statistical test (incorporating the five measures). Results: There were no statistically significant differences between groups. For the combined sample, strength on the fractured leg (2.63, 95% CI: 0.86, 4.40 kg) and non-fractured leg (1.36, 95% CI: 0.12, 2.70 kg) were statistically higher than baseline values. Conclusions: There were no between group differences in physical function. Overall, older adults from both groups had small significant improvements in bilateral leg strength at final assessment, but below age-matched normative values.
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