Peninsula Clinical School, Monash University, Frankston Australia; National Centre for Healthy Ageing, Melbourne, Australia; Academic Unit, Peninsula Health, Frankston Australia.
Physiotherapy Department, Peninsula Health, Frankston, Australia.
Physiotherapy. 2024 Sep;124:51-64. doi: 10.1016/j.physio.2024.05.002. Epub 2024 May 14.
Determine the feasibility of allied health assistant (AHA) management of people with hip fracture an acute hospital.
Assessor-blind, parallel, feasibility randomised controlled trial with qualitative component.
Acute orthopaedic ward.
People with surgically-managed hip fracture, who walked independently pre-fracture and had no cognitive impairment.
Rehabilitation from an AHA, under the supervision of a physiotherapist, compared with rehabilitation from a physiotherapist.
Feasibility was evaluated according to focus areas of demand, acceptability, practicality and implementation. Secondary outcomes included estimates of effect of adherence to hip fracture mobilisation guidelines, discharge destination, 30-day readmission, functional activity, and length of stay.
Fifty people were allocated to receive rehabilitation from an AHA (n = 25) or physiotherapist (n = 25). AHA rehabilitation had high demand with 60% of eligible participants recruited. Satisfaction with AHA rehabilitation was comparable with physiotherapy rehabilitation (acceptability). The AHA group received an average of 11 min (95% CI 4 to 19) more therapy per day than the physiotherapy group (implementation). The AHA group may have had lower cost of acute care (MD -$3 808 95% CI -7 651 to 35) and adverse events were comparable between groups (practicality). The AHA group may have been 22% (HR 1.22, 95% CI 0.92 to 1.61) more likely to walk on any day and may have had a shorter length of stay (MD -0.8 days, 95% CI -2.3 to 0.7).
AHA management of patients with hip fracture was feasible and may improve adherence to mobilisation guidelines and reduce cost of care and length of stay.
ACTRN12620000877987. CONTRIBUTION OF THE PAPER.
确定在急性医院中由辅助医疗人员（AHA）管理髋部骨折患者的可行性。
评估员盲法、平行、可行性随机对照试验，具有定性部分。
急性骨科病房。
接受手术治疗的髋部骨折患者，这些患者在骨折前能够独立行走且无认知障碍。
在物理治疗师的监督下，由 AHA 进行康复治疗，与由物理治疗师进行康复治疗进行比较。
根据需求、可接受性、实用性和实施的重点领域评估可行性。次要结果包括对遵循髋部骨折活动指南的依从性、出院去向、30 天再入院、功能活动和住院时间的影响的估计。
50 名患者被分配接受 AHA（n=25）或物理治疗师（n=25）的康复治疗。AHA 康复治疗的需求很高，有 60%的合格参与者被招募。对 AHA 康复治疗的满意度与物理治疗康复治疗相当（可接受性）。与物理治疗组相比，AHA 组每天接受的治疗时间平均多 11 分钟（95%CI 4 至 19）（实施）。AHA 组的急性护理成本可能较低（MD -$3808，95%CI -7651 至 35），且两组的不良事件相似（实用性）。AHA 组在任何一天行走的可能性可能增加 22%（HR 1.22，95%CI 0.92 至 1.61），并且可能住院时间更短（MD -0.8 天，95%CI -2.3 至 0.7）。
AHA 管理髋部骨折患者是可行的，可能会提高对活动指南的依从性，并降低医疗成本和住院时间。
ACTRN12620000877987。
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