Effect of an additional health professional-led exercise programme on clinical health outcomes after hip fracture

Purpose: To examine the effect of an additional two-week health professional-led functional exercise programme compared to usual care for patients after hip fracture during a short-term nursing home stay directly after hospital discharge. Method: One hundred and forty participants, 65 years or older with hip fracture, admitted to a short-term nursing home stay were randomised to an intervention group or control group. Participants in the intervention group (n= 78) received the experimental programme consisted of functional exercises, performed by health care professionals up to four times a day, seven days a week, in addition to usual care during a two-week short-term nursing home stay. Participants in the control group (n= 62) received usual care alone. Primary outcome was Short Physical Performance Battery (SPPB). Secondary outcomes were Timed Up & Go (TUG), New Mobility Score (NMS), UCLA activity scale, Fall efficacy scale international (FES-I), The EuroQol five dimensionfive-level questionnaire (EQ-5D-5L), and numeric rating scale (NRS) for pain. Outcome measures were assessed after two weeks in a short-term nursing home stay and three months after hip fracture surgery. The activity monitor ActivPal registered activity during the two-week short-term nursing home stay.Results: No statistically significant differences between groups was found in any outcomes after two weeks or three months (p>0.05). There were statistically significant within-group improvements in primary outcome SPPB and in most secondary outcomes at all time points in both groups (p > 0.05). Conclusions: A two-week health professional-led functional exercise programme in addition to usual care demonstrated no difference in clinical outcomes compared to usual care alone up to three months after hip fracture. The patients with hip fracture are fragile and vulnerable in this early phase, and usual physiotherapy may be sufficient to improve their physical function. Trial registration: ClinicalTrials.gov NCT02780076