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High Intensity Physiotherapy for Hip Fractures (HIP4hips)

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ClinicalTrials.gov Identifier: NCT02088437
Recruitment Status : Completed
First Posted : March 17, 2014
Last Update Posted : December 31, 2015
Sponsor:
Information provided by (Responsible Party):
Lara Kimmel, The Alfred

Brief Summary:

Every day, more than 40 Australian break their hip, Most are over the age of sixty five. Hip fractures are a significant problem for the older people, the hospital system and community as a whole because of the increasing numbers of fractures and the cost of hospitalisation and ongoing care. After one year, less than half of all people with a hip fracture can walk as well as they did before the fracture. Physiotherapy in the acute hospital setting is an integral part of patient care, although the intensity of physiotherapy a patient receives is variable and the optimal number of treatment sessions per day remains unknown. Studies in other patient groups have shown that increased physiotherapy can improve patient outcomes by increasing muscle strength and mobility. It can also reduce the negative effects of bed rest such as muscle wasting, blood clots in the lungs or leg veins and chest infections such as pneumonia. This study aims to investigate the effectiveness of an intensive physiotherapy program in hip fracture patients to further understand this and the effect it has on patient function.

In this research the investigators will randomly allocate patients into 2 groups; usual care and intensive physiotherapy. The usual care group will have physiotherapy treatment daily whereas the intensive physiotherapy group will have an additional daily treatment by a physiotherapist as well as a daily treatment by an allied health assistant. The objectives are to achieve better functional outcomes in the patient's hospital stay (ie improved mobility), reduce the time for patients to be physically ready to go home, increase the number of patients able to go directly home or to fast stream rehabilitation (rather than a slow stream option).

If increased intensity of physiotherapy is found to improve patient's mobility outcomes, this research will provide the confidence to endorse a change to current clinical practice.


Condition or disease Intervention/treatment Phase
Hip Fractures Other: Intensive physiotherapy Other: Usual Care Not Applicable

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 92 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Care Provider, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: High Intensity Physiotherapy for Hip Fractures in the Acute Hospital Setting
Study Start Date : March 2014
Actual Primary Completion Date : January 2015
Actual Study Completion Date : September 2015

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Active Comparator: Usual care
usual care physiotherapy - once daily treatment whilst inpatient in acute hospital
Other: Usual Care
once daily physiotherapy whilst acute hospital inpatient

Experimental: Intensive physiotherapy
additional once daily physiotherapy and once daily allied health assistant intervention
Other: Intensive physiotherapy
additional once daily physiotherapy and once daily allied health assistant intervention (equals two more treatments) whilst an inpatient in acute hospital




Primary Outcome Measures :
  1. modified IOWA Level of Assistance Scale [ Time Frame: 5 days ]
    Functional score measuring 6 mobility domains


Secondary Outcome Measures :
  1. length of stay - acute and rehabilitation [ Time Frame: participants will be followed for duration of hospital stay - average one month ]
    the length of acute hospital stay and rehabilitation stay - until discharge home or to a long term facility

  2. timed up and go [ Time Frame: 5 days ]
  3. Glasgow Outcomes Score -Extended [ Time Frame: 6 months ]
  4. discharge destination [ Time Frame: participants will be followed until discharge from the acute hospital - average 10 days ]
    discharge destination from the acute hospital - options include: home, fast stream rehabilitation, slow stream rehabilitation, long term facility

  5. physical readiness for discharge [ Time Frame: average one month ]
    when a patient is deemed physically ready go home - eg can access their house and mobilise within house and outdoors

  6. 12-Item Short Form Health Survey (SF-12) [ Time Frame: 6 months ]
  7. EuroQOL five dimensions questionnaire (EQ-5D) [ Time Frame: 6 months ]


Information from the National Library of Medicine

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Ages Eligible for Study:   65 Years and older   (Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Admission to The Alfred with an isolated hip fracture and treated with internal fixation, aged 65 or above

Exclusion Criteria:

  • fracture is in the sub-trochanteric region of the femur,
  • if it is pathological,
  • if post operative orders are for non-weight bearing on the operated hip,
  • if they were unable to mobilise independently (or with gait aid) prior to admission,
  • or if they were admitted from a nursing home.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02088437


Locations
Australia, Victoria
The Alfred
Melbourne, Victoria, Australia, 3181
Sponsors and Collaborators
The Alfred
Investigators
Principal Investigator: Lara A Kimmel, B.Physio The Alfred

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Lara Kimmel, Principal Investigator, The Alfred
ClinicalTrials.gov Identifier: NCT02088437     History of Changes
Other Study ID Numbers: 32/14
First Posted: March 17, 2014    Key Record Dates
Last Update Posted: December 31, 2015
Last Verified: December 2015

Additional relevant MeSH terms:
Fractures, Bone
Hip Fractures
Wounds and Injuries
Femoral Fractures
Hip Injuries
Leg Injuries