Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Copenhagen, Denmark.
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
BMC Geriatr. 2022 Apr 27;22(1):370. doi: 10.1186/s12877-022-03039-x.
A Rehabilitation Program for older adults with hip fracture (HIP-REP) based on Activity of Daily Living has been developed. The objectives of this study were to assess the feasibility and safety of the HIP-REP program to inform a future randomized controlled trial (RCT).
A feasibility study Inspired by the Complex-intervention development (Medical Research Council framework phase II) design using quantitative and qualitative research methods were conducted. Eighteen participants (above 65 years) with hip fracture were recruited from the orthopedic wards. The setting was cross sectoral including Copenhagen University Hospital, Herlev and Gentofte and rehabilitation centers in Herlev, Gentofte and Lyngby-Taarbæk municipalities. A cross-sectoral rehabilitation intervention tailored to the needs of older adults with hip fracture highlighting systematic goal setting and strategies focused on activities of daily living was conducted. Pre-defined feasibility criteria: participants recruitment and retention, duration of measuring the outcome, adherence to intervention, and adverse events, along with self-reported outcomes and an objective measurement of performance in activity of daily living. Focus groups were analyzed using a deductive manifest content analysis approach. Descriptive statistical analysis and paired t-tests were performed for assessing change in outcome measures.
Recruitment rate was 4.5/month. Outcome measures were performed but length and number of questionnaires were a burden. Thirteen out of eighteen participants completed the study three dropped out and two died. Adherence among the 13 was 100%. Focus group revealed issues regarding coordinating the intervention, ensuring procedural processes across sectors regarding recruitment of participants, and documentation in the database. Participants expressed satisfaction with the intervention and felt safe during intervention. Assessment of Motor and Process Skills showed better increase between (range 0.4 to 1.6) in ADL motor ability measures and better increase between (range 0.4 to 0.7) for process ability. No clear association between outcome improvements and intervention adherence.
The cross-sectoral intervention based on daily activities was feasible and safe for older adults with hip fracture. A future RCT, with an improved recruitment strategy and reduced number of outcome measures will evaluate the effectiveness in improving independence and safety performance of activity of daily living.
ClinicalTrials.gov ID: NCT03828240 . Registered on January 29, 2019.
已经开发出一种基于日常生活活动的针对老年髋部骨折患者的康复计划（HIP-REP）。本研究的目的是评估 HIP-REP 计划的可行性和安全性，以为未来的随机对照试验（RCT）提供信息。
本研究采用基于复杂干预措施开发（医学研究理事会框架第二阶段）的设计，结合定量和定性研究方法进行。从骨科病房招募了 18 名（65 岁以上）髋部骨折患者。该研究设置为跨部门的，包括哥本哈根大学医院、赫勒和根措夫特以及赫勒、根措夫特和林比-塔勒比克市的康复中心。针对髋部骨折老年人的需求进行了跨部门的康复干预，重点是系统的目标设定和以日常生活活动为重点的策略。预定义的可行性标准包括：参与者的招募和保留、测量结果的持续时间、对干预的依从性以及不良事件，以及自我报告的结果和日常生活活动的客观测量。使用演绎主题内容分析方法对焦点小组进行分析。对结果测量的变化进行描述性统计分析和配对 t 检验。
招募率为 4.5/月。进行了结果测量，但问卷的长度和数量是一种负担。18 名参与者中有 13 名完成了研究，3 名退出，2 名死亡。13 名参与者的依从性为 100%。焦点小组揭示了协调干预、确保跨部门参与招募的程序流程以及数据库中的文档方面的问题。参与者对干预表示满意，并在干预过程中感到安全。运动和过程技能评估显示，日常生活活动的运动能力测量中（范围 0.4 至 1.6）的改善程度更好，过程能力的改善程度更好（范围 0.4 至 0.7）。结果的改善与干预的依从性之间没有明确的关联。
基于日常生活活动的跨部门干预对髋部骨折的老年人是可行且安全的。未来的 RCT 将采用改进的招募策略和减少结果测量的数量，以评估改善日常生活活动独立性和安全性表现的效果。
ClinicalTrials.gov ID：NCT03828240。注册于 2019 年 1 月 29 日。
