Extract
Question: In community-dwelling frail elderly patients with hip
fracture, does an extended physical therapy program that includes progressive
resistance training improve physical function and reduce disability more than
low-intensity home exercise?Design: Randomized (allocation
concealed)*, blinded (outcome
assessors), controlled trial with 6-month follow-up.*Information provided by author.Setting: St. Louis, Missouri.Patients: 90 community-dwelling patients =65 years of age (mean
age, 81 y; 74% women) who were discharged from standard physical therapy
prescribed for a recent fracture of the proximal part of the femur. Other
inclusion criteria were an evaluation within 16 weeks of hip fracture, a
modified Physical Performance Test (PPT) score of between 12 and 28, and a
difficulty or need for assistance with =1 activity of daily living (ADL).
Exclusion criteria included pathological fracture, bilateral femoral fracture,
or previous contralateral femoral fracture; dementia, cognitive impairment, or
a Short Blessed Test score of =11; an inability to walk 50 feet (15.24
meters) with use of an assistive device; visual or hearing impairments;
cardiopulmonary or neuromuscular disease that would preclude participation in
a weighttraining program; conditions that would not improve with exercise
training; a recent course of medication for osteoporosis or recent hormone
therapy; or a life expectancy of <1 year. Although follow-up was 94%, 24%
of patients did not complete the extended program.