Effects on function and quality of life of postoperative home-based physical therapy for patients with hip fracture.

OBJECTIVE

To evaluate the effects of a 3-month home-based physical therapy (PT) program for patients with hip fracture after surgery.

DESIGN

Randomized controlled trial.

SETTING

Home.

PARTICIPANTS

Twenty-five patients recently discharged from an acute orthopedic department.

INTERVENTIONS

Patients were randomized to the home-based PT group (n=13), where they received home-based PT 8 times from discharge to month 3 postdischarge, or to the control group (n=12). The home-based PT program included exercises for muscle strengthening, range of motion (ROM), balance, and functional training. Patients in the control group were instructed to practice the exercise program given at bedside before discharge.

MAIN OUTCOME MEASURES

Patients were evaluated for hip ROM, strength, walking velocity, Harris hip score, and health-related quality of life (HRQOL) at the week of discharge and at 1, 3, and 6 months after discharge.

RESULTS

The baseline characteristics showed no difference between the 2 groups. Harris score of the home-based PT group progressed from 58.6+/-8.5 to 90.1+/-5.4 at month 3, whereas Harris score of the control group progressed from 54.6+/-14.5 to 77.4+/-10.0 (P<.01). Scores of the psychologic domain of HRQOL for the home-based PT group were significantly better at month 1 (P<.05) and month 3 (P<.01) after discharge. Moreover, the physical domain score of the home-based PT group was also significantly better (P<.05) at 3 months after discharge.

CONCLUSIONS

Home-based PT programs could help patients regain function and HRQOL earlier.