Long-term effects of home rehabilitation after hip fracture – 1-year follow-up of functioning, balance confidence, and health-related quality of life in elderly people

Abstract

Purpose. To investigate the long-term effects of home rehabilitation (HR) after hip fracture in elderly people.

Method. A randomized, controlled longitudinal study on geriatric hospital-based HR was compared with conventional care (CC) in 102 patients. Independence in activities of daily living (ADL), frequency of activity, basic physical performance, balance confidence, health-related quality of life, mood and perceived recovery were measured 6 and 12 months after discharge.

Results. One year post-discharge the HR participants reported significantly higher degree of independence in self-care and locomotion, as well as of balance confidence in stairs and instrumental activities and perceived physical function, than the CC group. One year after discharge 14 persons (29%) in the HR group and five persons (9%) in the CC group considered themselves fully recovered.

Conclusions. The positive long-term effects were more pronounced among the participants in the HR group than among those who received CC, possibly due to the early start of the HR programme in hospital and its focus on self-efficacy and training of daily activities. However, one year after discharge a mojority of participants in both groups did not consider themselves to be fully recovered when they compared to their situation before the fracture.

Keywords:

• Hip fracture
• home rehabilitation
• independence
• balance confidence
• daily activities
• health-related quality of life

Acknowledgements

We thank all the study participants for their valuable contribution and our colleagues at Sahlgrenska University Hospital for their support and assistance in the study. The study was financially supported by the Vårdal Institute, the Hjalmar Svensson Foundation and the Geriatric Section of the Swedish Association of Registered Physiotherapists. All three authors were involved in the design of the study. The data were collected by LZ, who wrote the manuscript. MK and KF supervised and commented on the analyses and the writing of the manuscript.