A quarter million (250,000) Americans break their hip each year, and only half of those individuals remain independent at 2 years after their fracture. While physical therapy is standard after hip fracture, it may not be enough. A 2004 study found that additional outpatient physical therapy after standard hip fracture rehabilitation is beneficial, but may not be cost-effective. Hip fracture patients are typically discharged from physical therapy with a home exercise program and written instructions, but without further supervision.
Physical therapy researchers in Boston, Massachusetts recently completed a 4-year randomized controlled clinical trial to examine the effectiveness of a post-rehabilitation home exercise program in functionally limited older adults suffering a hip fracture. They published their findings in the prestigious Journal of the American Medical Association (JAMA). The purpose of their study was to determine the efficacy of a functionally oriented, physical therapist-supervised home exercise program for post-rehabilitation hip fracture patients.
The researchers randomly assigned nearly 200 functionally limited patients over 60 years old to either an exercise group or control group after finishing traditional hip fracture rehabilitation. The exercise group performed 6 months of exercise at home, while the control group received education at home.
The home exercise program was performed 3 times per week for 6 months. A physical therapist visited the patient in their home 3 times for 1 hour to instruct and monitor the program. The exercise program utilized TheraBandTM exercise bands using the “Strong for Life” exercise program. The exercise program focused on functional movements rather than traditional strength impairments. Patients also performed other functional exercises using steps and weighted vests. The patients received monthly phone calls and received cognitive and behavioral strategies as needed.
The patients in the exercise group significantly increased their function (16%), mobility (4%), and physical activity levels (7%) compared to the control group. There were no adverse events despite the functional limitations of the exercise group.
The researchers concluded that home exercise after hip fracture rehabilitation with TheraBand exercise bands could result in modest improvement in physical function after 6 months. They stated, “With this intervention, there was no need for participants to travel outside their home or to use expensive equipment.” Furthermore, “participants were able to perform the exercise effectively and safely in their home.”
REFERENCE: Latham NK, et al. Effect of a home-based exercise program on functional recovery following hip fracture. A randomized clinical trial. JAMA. 2014. 311(7):700-08.
Disclosure: TheraBand Academy provided the bands used in this study.