Longer Rehab Improves Hip Fracture Outcomes

Supervised exercise, weight training keeps elderly patients mobile, independent

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TUESDAY, Aug. 17, 2004 (HealthDayNews) -- An extra six months of supervised outpatient rehabilitation helps elderly hip fracture patients achieve a better recovery, says a Washington University School of Medicine study that challenges the current standard therapy.

The study also found that elderly people with hip fractures can benefit from progressive resistance weight training. It was previously believed they were too frail for such exercise.

Longer rehabilitation led to real "functional improvements" in elderly patients, researcher Dr. Ellen F. Binder, of Barnes-Jewish Hospital in St. Louis, said in a prepared statement.

"It's great to improve strength and balance," she said, "but the key is whether that translates into being able to do more with less outside help."

Typical hip fracture rehabilitation involves up to 16 weeks of home-based therapy. After that, few patients get referred to outpatient facilities to continue their rehabilitation.

This study, which appears in the Aug. 18 issue of the Journal of the American Medical Association, included 90 elderly hip fracture patients who had just completed the standard course of home-based therapy. They were divided into two groups. The first group received six months of supervised physical therapy and exercise training, while the second group received instructions and brief training in exercises they did at home for six months.

In their first phase, the supervised group did exercises to improve flexibility, balance, coordination, motor speed and strength. The exercises were tailored to suit each individual's needs and became progressively more difficult as the patients improved.

In the second phase, they did progressive resistance training using weight machines.

The home-based therapy patients exercised on their own at least three times a week, without weight training.

Both groups of patients were prescribed standard dosages of calcium and vitamin D replacement therapy, to help strengthen bones.

The researchers measured the study subjects' muscle strength, balance, flexibility, bone density, mobility and ability to do daily tasks.

The patients who received the supervised therapy showed much more improvement than those who did the home-based therapy. Bone density in both groups did not decline during the study.

Binder, a geriatric specialist, said she was encouraged by the study results. "Our goal is to help elderly hip fracture patients live independently in their own homes for as long as possible, which is usually an important component of their quality of life."

More information

The U.S. National Center for Injury Prevention and Control has more about falls and hip fractures.

SOURCE: Washington University School of Medicine, news release, Aug. 17, 2004

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