The Stronger at Home Study

Dr. Mohammad Auais, PhD

Status: Completed

Conditions: Hip Fractures

Treatments: Other: Conventional care; Other: Rehabilitation Program; Other: Pain self management

Study type: Interventional

Funder types: Other

Identifiers

NCT04228068

REH-721-18

Details and patient eligibility

About

Hip fracture is a major health problem facing older adults. Hip fractures result in higher mortality, morbidity, and costs than all other osteoporotic fractures combined. When returning home following hip fracture surgery, patients are at high risk of adverse outcomes (e.g., secondary fractures, institutionalisation, and death).

Objectives: This study aims to finalize and pilot test a new program of care including a user-friendly toolkit containing a home-based physiotherapy exercise and pain management program to help community-dwelling older adults recover after hip fractures.

Methods: This study will be two stages: First, finalizing the program. The investigators have created a self-explanatory toolkit that includes an illustrated exercise program based on a critical analysis of previous programs for hip fracture patients. The investigators will organize focus groups and conduct semi-structured interviews with patients, caregivers, policymakers, and healthcare providers to review the program and provide feedback.

Second, conducting a feasibility study. The investigators will pilot the program in a randomized trial with community-dwelling hip fracture patients and compare the intervention with conventional care.

Expected Outcomes: While the number of hip fracture survivors is increasing, they are becoming frailer, and their functional recovery has not improved, making this study timely and relevant. With the current focus on helping older adults "age in place," the proposed project addresses a vital health system challenge: helping older hip fracture patients access proper rehabilitation, so they can stay independent in their homes.

Enrollment: 32 patients

Sex: All

Ages: 65 to 120 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• hip fracture patients who are 65 years or older
• being discharged to home or retirement home .

Exclusion criteria

• participants with a terminal illness or significant contraindications preventing exercising (e.g. rapidly progressing neurological disease),
• live away more than 30 km from the centre of the city, and
• cannot sign the consent form and no proxy available to sign.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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32 participants in 2 patient groups

Intervention

Experimental group

Description:

The exercise program will be for the first 12 weeks after returning home. The intervention will be provided after patients return home. Each patient will receive 7 home visits in total over the intervention period by a physiotherapist (PT) and/or a physiotherapy assistant (PTA). Participants in the intervention group will receive a copy of the Toolkit before discharge from the hospital, and the study coordinator will walk them through it and explain what should be expected during the intervention period.

Treatment:

Other: Pain self management

Other: Rehabilitation Program

Conventional care

Active Comparator group

Description:

Usual care

Treatment:

Other: Conventional care