髋部骨折后，额外的由健康专业人员主导的运动方案对临床健康结局的影响。

Effect of an additional health-professional-led exercise programme on clinical health outcomes after hip fracture.

机构信息

Department of Medical Research, Baerum Hospital, Vestre Viken Hospital Trust, Drammen, Norway.

Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

出版信息

Physiother Res Int. 2021 Apr;26(2):e1896. doi: 10.1002/pri.1896. Epub 2021 Jan 28.

DOI:10.1002/pri.1896

PMID:33506973

Abstract

PURPOSE

To examine the effect of an additional 2-week health professional-led functional exercise programme compared to usual care for patients after hip fracture during a short-term nursing home stay directly after hospital discharge.

METHOD

One hundred and forty participants, 65 years or older with hip fracture, admitted to a short-term nursing home stay were randomised to an intervention group or control group. Participants in the intervention group (n = 78) received the experimental programme consisted of functional exercises, performed by health care professionals up to four times a day, 7 days a week, in addition to usual care during a 2-week short-term nursing home stay. Participants in the control group (n = 62) received usual care alone. Primary outcome was Short Physical Performance Battery (SPPB). Secondary outcomes were Timed Up & Go, New Mobility Score, The University of California, Los Angeles Activity Scale, Fall Efficacy Scale International, The EuroQol five dimension five-level questionnaire, and Numeric Rating Scale for pain. Outcome measures were assessed after 2 weeks in a short-term nursing home stay and 3 months after hip fracture surgery. The activity monitor ActivPal registered activity during the 2-week short-term nursing home stay.

RESULTS

No statistically significant differences between groups was found in any outcomes after 2 weeks or 3 months (p > 0.05). There were statistically significant within-group improvements in primary outcome SPPB and in most secondary outcomes at all time points in both groups (p > 0.05).

CONCLUSIONS

A 2-week health professional-led functional exercise programme in addition to usual care demonstrated no difference in clinical outcomes compared to usual care alone up to 3 months after hip fracture. The patients with hip fracture are fragile and vulnerable in this early phase, and usual physiotherapy may be sufficient to improve their physical function.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02780076.

摘要

目的

研究与常规护理相比，在髋部骨折患者出院后短期入住疗养院期间，由健康专业人员提供的为期 2 周的额外功能性锻炼方案对他们的短期影响。

方法

140 名 65 岁及以上、髋部骨折、入住短期疗养院的患者被随机分为干预组和对照组。干预组（n=78）患者接受实验性方案，该方案包括由医疗保健专业人员在 2 周的短期疗养院期间每天进行多达 4 次的功能性锻炼，除常规护理外还接受额外的治疗。对照组（n=62）仅接受常规护理。主要结果是简短体能表现电池测试（SPPB）。次要结果是起立行走计时测试、新移动评分、加利福尼亚大学洛杉矶活动量表、跌倒效能国际量表、欧洲五维健康量表、疼痛数字评分量表。在短期疗养院期间和髋部骨折手术后 3 个月评估了结果测量值。在 2 周的短期疗养院期间，使用活动监测器 ActivPal 记录了活动量。