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Age and Ageing Advance Access published online on November 18, 2008
Age and Ageing, doi:10.1093/ageing/afn217
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© The Author 2008. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Mobility training after hip fracture: a randomised controlled trial

Anne M. Moseley1, Catherine Sherrington1,2, Stephen R. Lord2, Elizabeth Barraclough2,3, Rebecca J. St George2 and Ian D. Cameron3

1 The George Institute for International Health, University of Sydney, Sydney, NSW 2000, Australia
2 Prince of Wales Medical Research Institute, Cnr Barker Street & Easy Street, Randwick, NSW 2031, Australia
3 Rehabilitation Studies Unit, Faculty of Medicine, University of Sydney, Ryde, NSW 1680, Australia

Address correspondence to: A. M. Moseley. Tel: (+61) 2 9657 0385; Fax: (+61) 2 9657 0301. Email: amoseley{at}george.org.au

Objective: to compare the effects of two different exercise programmes after hip fracture.

Design: assessor-blinded randomised controlled trial.

Setting: hospital rehabilitation units, with continued intervention at home.

Subjects: 160 people with surgical fixation for hip fracture transferred to inpatient rehabilitation.

Method: in addition to other rehabilitation strategies, the intervention group received a higher dose (60 min/day) exercise programme conducted whilst standing and the control group received a lower dose exercise programme (30 min/day) primarily conducted whilst seated/supine. The primary outcome measures were knee extensor muscle strength in the fractured leg and walking speed, measured at 4 and 16 weeks.

Results: 150 participants (94% of those recruited) completed the trial. There were no differences between the groups for the two primary outcome measures. Post hoc analyses revealed increased walking speed among those in the higher dose, weight-bearing exercise group with cognitive impairment at 4 and 16 weeks.

Conclusions: there was no benefit (or harm) due to the higher dose, weight-bearing exercise programme with respect to the primary outcome measures. However, people with hip fracture and cognitive impairment gained greater benefit from the higher dose programme than from the lower dose programme.

Keywords: hip fracture, mobilisation, physical therapy, rehabilitation, cognitive impairment, elderly

Received 23 August 2007; accepted in revised form 2 July 2008.


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