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Multifaceted Home-Based PT Does Not Aid Walking After Hip Fracture

Findings based on intervention designed to help older persons recovering from hip fracture

FRIDAY, Sept. 20, 2019 (HealthDay News) — A multicomponent home-based physical therapy intervention does not improve the ability of older patients recovering from hip fracture to walk again, according to a study published in the Sept. 10 issue of the Journal of the American Medical Association.

Jay Magaziner, Ph.D., from the University of Maryland School of Medicine in Baltimore, and colleagues compared the impact of a multicomponent, home-based physical therapy intervention (aerobic, strength, balance, and functional training) to that of an active control intervention (transcutaneous electrical nerve stimulation [TENS] and active range-of-motion exercises) on the ability of 210 older adults (mean age 80.8 years) to walk after a hip fracture. Patients from three U.S. clinical centers were randomly assigned to an intervention (between Sept. 16, 2013, and June 20, 2017) and were reassessed 16 and 40 weeks later.

The researchers found that 22 of 96 training participants (22.9 percent) and 18 of 101 active control participants (17.8 percent) became community ambulators. At least one reportable adverse event occurred in 16.2 percent of training participants and 14.3 percent of control participants during the intervention period. Adverse events included falls (training, six [5.7 percent]; control, four [3.8 percent]), femur/hip fracture (two in each group), pneumonia (training, two; control, zero), urinary tract infection (training, two; control, zero), dehydration (training, zero; control, two), and dyspnea (training, zero; control, two).

“Among older adults with a hip fracture, a multicomponent home-based physical therapy intervention designed to improve endurance, strength, balance, and function did not result in a statistically significant improvement in participants’ ability to walk 300 m or more in 6 minutes after 16 weeks as compared with an active control intervention that included TENS and active range-of-motion exercises,” the authors write.

Several authors disclosed financial ties to the pharmaceutical and biotechnology industries.

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