Biohealth Research Institute (ibs.Granada) Physical Medicine and Rehabilitation Service, Virgen de las Nieves University Hospital, Granada, Spain.
PA-HELP "Physical Activity for HEaLth Promotion" Research Group, Department of Physical and Sport Education, Faculty of Sports Sciences, University of Granada, Granada, Spain.
J Telemed Telecare. 2024 Apr;30(3):549-558. doi: 10.1177/1357633X211073256. Epub 2022 Jan 21.
Telerehabilitation has emerged in the last decade as a promising alternative to conduct the rehabilitation process at home. However, there are no studies testing the effects of telerehabilitation interventions for patients with hip fracture on quality of life nor psychological factors, whereas the evidence on fitness level is scarce. Thus, the aim of this study is to test the effects of the @ctivehip telerehabilitation program on the quality of life, psychological factors and fitness level of patients who had suffered a hip fracture.
The present study is a non-randomized clinical trial that includes patients older than 65 years old with a hip fracture and their family caregivers (ClinicalTrials.gov; Identifier: NCT02968589). Per-protocol (64 participants) and intention-to-treat (71 participants) analyses were performed, the first being the main analysis. The intervention group received a home-based multidisciplinary telerehabilitation intervention, called @ctivehip, that lasted 12 weeks. The control group received the traditional care and rehabilitation provided by the Andalusian Public Health Care System. The outcomes measured were the patients' quality of life through the EuroQol Quality of Life Questionnaire (EQ-5D), physiological factors (anxiety and depression) using the Hospital Anxiety and Depression Scale (HADS) and the fitness level, assessed with the International Fitness Scale.
The quality of life of the telerehabilitation group increased, while the control group scored worsened at the 3-month follow-up (medium effect size: 0.66 SDs; = 0.006). The telerehabilitation group demonstrated a greater decrease than the control group in the total HADS score (medium effect size: -0.50 SDs; = 0.015). Lastly, the telerehabilitation group recovered a fitness level close to the pre-hip fracture in comparison with the control group (small effect size: 0.49 SDs; = 0.022).
The @ctivehip telerehabilitation program seems to be a promising treatment to improve the quality of life and psychological factors (i.e. anxiety and depression) of older adults after a hip fracture, as well as to recover their previous fitness level.
远程康复在过去十年中作为一种在家中进行康复治疗的有前途的替代方法出现。然而，目前尚无研究测试远程康复干预对髋部骨折患者生活质量和心理因素的影响，而有关健身水平的证据也很少。因此，本研究旨在测试@ctivehip 远程康复计划对髋部骨折患者的生活质量、心理因素和健身水平的影响。
本研究为非随机临床试验，纳入年龄大于 65 岁的髋部骨折患者及其家属（ClinicalTrials.gov；标识符：NCT02968589）。进行了意向治疗（71 名参与者）和按方案（64 名参与者）分析，前者为主要分析。干预组接受了基于家庭的多学科远程康复干预，称为@ctivehip，持续 12 周。对照组接受了安达卢西亚公共医疗保健系统提供的传统护理和康复。测量的结果是患者通过欧洲五维健康量表（EQ-5D）评估的生活质量、使用医院焦虑和抑郁量表（HADS）评估的生理因素（焦虑和抑郁）和使用国际健康量表评估的健康水平。
远程康复组的生活质量提高，而对照组在 3 个月随访时得分恶化（中等效应量：0.66 标准差； = 0.006）。与对照组相比，远程康复组的 HADS 总分下降更大（中等效应量：-0.50 标准差； = 0.015）。最后，与对照组相比，远程康复组恢复了接近骨折前的健康水平（小效应量：0.49 标准差； = 0.022）。
@ctivehip 远程康复计划似乎是一种有前途的治疗方法，可以改善髋部骨折后老年人的生活质量和心理因素（即焦虑和抑郁），并恢复他们以前的健康水平。
