Rehabilitation, South Karelia Social and Health Care District, Valto Käkelän katu 3, FI-53130, Lappeenranta, Finland.
Aureolis Oy, Hevosenkenkä 3, FI-02600, Espoo, Finland.
BMC Geriatr. 2018 Oct 1;18(1):232. doi: 10.1186/s12877-018-0916-y.
Health concerns, such as frailty and osteoporotic fractures decrease functional capacity and increase use of health and social care services in the aging population. The ability to continue living at home is dependent on functional capacity, which can be enhanced by rehabilitation. We study the effects of a 12-month home-based physiotherapy program with 12-month follow-up on duration of living at home, functional capacity, and the use of social and health care services among older persons with signs of frailty, or with a recently operated hip fracture.
This is a non-blinded, parallel group, randomized controlled trial performed in South Karelia Social and Health Care District, Finland (population 131,000). Three hundred community-dwelling older persons with signs of frailty (age ≥ 65) and 300 persons with a recent hip fracture (age ≥ 60) will be recruited. Frailty is screened by FRAIL questionnaire and verified by modified Fried's frailty criteria. Both patient groups will be randomized separately to a physiotherapy and a usual care arm. Individualized, structured and progressive physiotherapy will be carried out for 60 min, twice a week for 12 months at the participant's home. The primary outcome at 24 months is duration of living at home. Our hypothesis is that persons assigned to the physiotherapy arm will live at home for six months longer than those in the usual care arm. Secondary outcomes are functional capacity, frailty status, health-related quality-of-life, falls, use and costs of social and health care services, and mortality. Assessments, among others Short Physical Performance Battery, Functional Independence Measure, Mini Nutritional Assessment, and Mini-Mental State Examination will be performed at the participant's home at baseline, 3, 6, and 12 months. Register data on the use and costs of social and health care services, and mortality will be monitored for 24 months.
Our trial will provide new knowledge on the potential of intensive, long-term home-based physiotherapy among older persons at risk for disabilities, to enhance functional capacity and thereby to postpone the need for institutional care, and diminish the use of social and health care services.
ClinicalTrials.gov Identifier: NCT02305433 , Registered Nov 28, 2014.
健康问题，如虚弱和骨质疏松性骨折，会降低老年人的身体机能，并增加对卫生和社会保健服务的使用。继续在家生活的能力取决于身体机能，而康复可以增强身体机能。我们研究了一项为期 12 个月的家庭为基础的物理治疗计划对虚弱或最近髋部骨折的老年人的居家时间、身体机能以及对社会和卫生保健服务的使用的影响，该计划有 12 个月的随访。
这是一项在芬兰南卡累利阿社会和卫生保健区（人口 131000）进行的非盲、平行组、随机对照试验。将招募 300 名有虚弱迹象（年龄≥65 岁）的社区居住的老年人和 300 名最近髋部骨折（年龄≥60 岁）的老年人。使用 FRAIL 问卷筛选虚弱，并通过改良 Fried 的虚弱标准进行验证。两组患者将分别随机分为物理治疗组和常规护理组。个体化、结构化和渐进式物理治疗将在参与者家中进行，每周两次，每次 60 分钟，持续 12 个月。24 个月时的主要结局是居家时间。我们的假设是，分配到物理治疗组的人将比常规护理组多在家生活 6 个月。次要结局是身体机能、虚弱状态、健康相关生活质量、跌倒、社会和卫生保健服务的使用和成本以及死亡率。评估将在参与者家中进行，包括短期身体表现电池、功能独立性测量、迷你营养评估和迷你精神状态检查，在基线、3、6 和 12 个月时进行。将监测 24 个月的社会和卫生保健服务使用和成本以及死亡率的登记数据。
我们的试验将提供关于在有残疾风险的老年人中进行强化、长期家庭为基础的物理治疗的潜力的新知识，以增强身体机能，从而推迟对机构护理的需求，并减少社会和卫生保健服务的使用。
ClinicalTrials.gov 标识符：NCT02305433，2014 年 11 月 28 日注册。
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