Effects of a 12-month home-based exercise program on functioning after hip fracture - Secondary analyses of an RCT

Paula K Soukkio; Sara A Suikkanen; Katriina T Kukkonen-Harjula; Hannu Kautiainen; Markku T Hupli; Eeva M Aartolahti; Sanna M Kääriä; Kaisu H Pitkälä; Sarianna Sipilä

doi:10.1111/jgs.17824

Effects of a 12-month home-based exercise program on functioning after hip fracture - Secondary analyses of an RCT

J Am Geriatr Soc. 2022 Sep;70(9):2561-2570. doi: 10.1111/jgs.17824. Epub 2022 May 18.

Authors

Paula K Soukkio^{1

2

3}, Sara A Suikkanen^{1

2}, Katriina T Kukkonen-Harjula¹, Hannu Kautiainen⁴, Markku T Hupli¹, Eeva M Aartolahti⁵, Sanna M Kääriä⁶, Kaisu H Pitkälä^{4

7}, Sarianna Sipilä^{2

3}

Affiliations

¹ Department of Rehabilitation, South Karelia Social and Health Care District (Eksote), Lappeenranta, Finland.
² Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
³ Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
⁴ Department of General Practice, University of Helsinki, Helsinki, Finland.
⁵ Institute of Rehabilitation, JAMK University of Applied Sciences, Jyväskylä, Finland.
⁶ Raatimiehet Oy, Lappeenranta, Finland.
⁷ Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland.

Abstract

Background: Long-term functional limitations are common after hip fractures. Exercise may alleviate these negative consequences but there is no consensus on an optimal training program. The objective was to study the effects of a 12-month home-based supervised, progressive exercise program on functioning, physical performance, and physical activity.

Methods: Secondary analysis of a randomized controlled trial targeting patients with surgical repair of a hip fracture, aged ≥60 years, Mini-Mental State Examination (MMSE) score of ≥12. The participants were randomized into Exercise (n = 61) or Usual care (n = 60). Assessments at baseline, 3, 6, and 12 months included Lawton's Instrumental Activities of Daily Living (IADL), Short Physical Performance Battery (SPPB), handgrip strength, and self-reported frequency of sessions of leisure-time physical activity. Analyzed using mixed-effects models.

Results: Participants' (n = 121) mean age was 81 years (SD 7), and 75% were women. The mean IADL score at baseline was 17.1 (SD 4.5) in the exercise group, and 17.4 (5.1) in the usual care group. The mean SPPB scores were 3.9 (1.6) and 4.2 (1.8), and handgrip strength was 17.7 (8.9) kg and 20.8 (8.0) kg, respectively. The age- and sex-adjusted mean changes in IADL over 12 months were 3.7 (95% CI 2.8-4.7) in the exercise and 2.0 (1.0-3.0) in the usual care group (between-group difference, p = 0.016); changes in SPPB 4.3 (3.6-4.9) and 2.1 (1.5-2.7) (p < 0.001); and changes in handgrip strength 1.2 kg (0.3-2.0) and 1.0 kg (-1.9 to -0.2) (p < 0.001), respectively. We found no between-group differences in changes in the frequency of leisure-time activity sessions.

Conclusion: A 12-month home-based supervised, progressive exercise program improved functioning and physical performance more than usual care among patients with hip fractures. However, the training did not increase leisure-time physical activity.

Keywords: functioning; hip fracture; home-based exercise; physical performance.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living
Aged, 80 and over
Exercise Therapy
Female
Hand Strength*
Hip Fractures* / surgery
Humans
Male
Physical Therapy Modalities

Abstract

Publication types

MeSH terms

Grants and funding