Effects of a home-based occupational therapy telerehabilitation via smartphone for outpatients after hip fracture surgery: A feasibility randomised controlled study

2020 ◽  
pp. 1357633X2093243
Author(s):  
Cabbee TL Li ◽  
Goris KN Hung ◽  
Kenneth NK Fong ◽  
Pablo Cruz Gonzalez ◽  
Shu-hong Wah ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Occupational Therapy ◽  
Comparison Group ◽  
Post Intervention ◽  
Hip Fracture Surgery ◽  
Home Based ◽  
Randomised Controlled ◽  
Fracture Surgery ◽  
Experimental Group

Introduction This study aimed to investigate the effects of a home-based occupational therapy telerehabilitation (TR) via smartphone in enhancing functional and motor performance and fall efficacy for outpatients receiving day hospital rehabilitation after hip fracture surgery in Hong Kong. Methods This was a feasibility randomised controlled trial with two groups – an experimental group and a comparison group – and a sample of 31 older adults attending a geriatric day hospital who had undergone hip fracture surgery within 12 weeks of diagnosis. Patients were assessed at baseline, immediately after a three-week intervention and at three-week post-intervention follow-up for motor performance, activities of daily living (ADL) functioning and fall efficacy. The experimental group received a home programme using the Caspar Health e-system and a mobile app for smartphones, while the comparison group received paper-and-pencil instructions for the home programme on a weekly basis for three weeks. Results Compared to the comparison group, significant improvements in fall efficacy and instrumental ADL performance at post intervention and follow-up were found in the experimental group. However, in the comparison group, inadequate social support was a factor contributing to better muscle strength testing in both the affected and non-affected legs. There were no significant differences between the two groups in regard to the other variables. Discussion This study supports the potential use of TR via smartphone as an alternative home programme for use in occupational therapy practice with older adults after hip fracture surgery.

scholarly journals Home-Based Multidisciplinary Rehabilitation following Hip Fracture Surgery: What Is the Evidence?

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Kathleen Donohue ◽  
Richelle Hoevenaars ◽  
Jocelyn McEachern ◽  
Erica Zeman ◽  
Saurabh Mehta
Keyword(s):  
Hip Fracture ◽  
Lower Extremity ◽  
Functional Status ◽  
Systematic Review Methodology ◽  
Balance Confidence ◽  
Hip Fracture Surgery ◽  
Lower Extremity Muscle ◽  
Home Based ◽  
Lower Extremity Strength ◽  
Fracture Surgery

Objective. To determine the effects of multidisciplinary home rehabilitation (MHR) on functional and quality of life (QOL) outcomes following hip fracture surgery.Methods. Systematic review methodology suggested by Cochrane Collboration was adopted. Reviewers independently searched the literature, selected the studies, extracted data, and performed critical appraisal of studies. Summary of the results of included studies was provided.Results. Five studies were included. Over the short-term, functional status and lower extremity strength were better in the MHR group compared to the no treatment group (NT). Over the long-term, the MHR group showed greater improvements in balance confidence, functional status, and lower extremity muscle strength compared to NT group, whereas the effect on QOL and mobility was inconsistent across the studies. Several methodological issues related to study design were noted across the studies.Conclusion. The MHR was found to be more effective compared to the NT in improving functional status and lower extremity strength in patients with hip fracture surgery. Results of this review do not make a strong case for MHR due to high risk of bias in the included studies. Further research is required to accurately characterize the types of disciplines involved in MHR and frequency and dosage of intervention.

scholarly journals Prognostic Factors for Mortality, Activity of Daily Living and Quality of Life in Taiwanese Older Patients within 1 Year following Hip Fracture Surgery

2022 ◽  
Vol 12 (1) ◽  
pp. 102
Author(s):  
Ming-Hsiu Chiang ◽  
Yu-Yun Huang ◽  
Yi-Jie Kuo ◽  
Shu-Wei Huang ◽  
Yeu-Chai Jang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Hip Fracture ◽  
Daily Living ◽  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
Hip Fracture Surgery ◽  
Fracture Surgery

Background. Hip fractures among older adults are a major public health concern worldwide. This study investigated the potential clinical factors that predict postoperative 1-year activities of daily living (ADL), quality of life (QoL), and mortality in Taiwanese older adults following hip fracture. Methods. This is a prospective cohort study enrolling older adults (≥60 years) who had undergone hip fracture surgery in a single medical center. The comprehensive clinical history of each patient was examined. QoL, ADL, and mortality events were recorded consecutively at 3, 6, and 12 months after operation. The multiple logistic regression model and the generalized estimating equation (GEE) were adopted to identify contributing factors for mortality and postoperative ADL and QoL prognosis, respectively. Results. Among 377 participants with hip fracture, 48 died within 1 year of the index operation. ADL and QoL considerably decreased at 3 months following hip surgery. Old age, high Charlson Comorbidity Index, and American Society of Anesthesiologists grading were crucial predictors for mortality at the 1-year follow-up. The generalized estimating equation analysis indicated that the length of postoperative follow-up time, serum albumin level, patient cognitive status, and handgrip strength were considerably associated with QoL and ADL recovery prognosis in the Taiwanese older adults following hip fracture. Conclusions. Hip fractures have long-lasting effects on the older adults. Our data imply several prognosis predicting parameters that may assist clinicians in accounting for an individual’s personalized risks in order to improve functional outcomes and reduce mortality.

scholarly journals Is Occupational Therapy After Hip Fracture Surgery Effective in Improving Function?

2019 ◽  
Vol 98 (4) ◽  
pp. 292-298
Author(s):  
Sang Yoon Lee ◽  
Se Hee Jung ◽  
Shi-Uk Lee ◽  
Yong-Chan Ha ◽  
Jae-Young Lim
Keyword(s):  
Hip Fracture ◽  
Occupational Therapy ◽  
Hip Fracture Surgery ◽  
Fracture Surgery

Patient-reported outcomes at acute hospital stay and four months after hip fracture surgery. A register and questionnaire study

2018 ◽  
Vol 6 (1) ◽  
pp. 119
Author(s):  
Berit Gesar ◽  
Carina Baath ◽  
Hanne Hedin ◽  
Ami Hommel
Keyword(s):  
Hip Fracture ◽  
Hospital Stay ◽  
Age Groups ◽  
Acute Hospital ◽  
Questionnaire Study ◽  
Hip Fracture Surgery ◽  
Quality Register ◽  
Patient Reported ◽  
Fracture Surgery

Introduction: The large and increasing number of hip fracture patients, in combination with the large impact that this is having on daily living activities, is emphasizing the importance of identifying factors that have a detrimental impact on post-operative outcomes. There are benefits to planning the ward in a way that prevents a steep decline in recovery after hip fracture surgery. Adding the patient`s perspective into the healthcare assessment, via shared healthcare decision-making, allows the patient’s needs and preferences to be taken fully into account. The aim of this study was to identify factors that predict how patients recover after hip fracture surgery.Methods: A descriptive quality register/questionnaire study in acute orthopaedic wards, 2 to 5 days after surgery, with a follow-up 4 months later. The patients included were ≥65 years of age and had been previously healthy and living independently before the hip fracture.Results: The participants in this study had returned to their own homes after 4 months, but only 21% reported themselves as being fully or almost fully recovered. In several domains of recovery, all 3 age groups (65-74, 75-84 and 85-97) reported different challenges both during their acute hospital stay and at the 4 months follow-up. The recovery phase is heterogeneous and requires individual care. The way that this is planned has an influence on patient outcome.Conclusion: Patients sustaining a hip fracture are heterogeneous and different age groups experience different challenges. At 4 months follow-up, one fifth of the participants reported themselves fully or almost fully recovered and most of them had returned to their own homes. The Swedish National Hip Fracture Register and the patient-reported questionnaires employed in this study are appropriate tools to audit further development of healthcare to improve quality of life after hip fracture surgery.

scholarly journals Comparison of regional with general anaesthesia on postoperative delirium (RAGA-delirium) in the older patients undergoing hip fracture surgery: study protocol for a multicentre randomised controlled trial

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016937 ◽  
Author(s):  
Ting Li ◽  
Joyce Yeung ◽  
Jun Li ◽  
Yan Zhang ◽  
Teresa Melody ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Hip Fracture ◽  
General Anaesthesia ◽  
Older Patients ◽  
Postoperative Delirium ◽  
Controlled Trial ◽  
Controlled Clinical Trial ◽  
Hip Fracture Surgery ◽  
Randomised Controlled ◽  
Fracture Surgery

IntroductionPostoperative delirium (POD) is a common serious postoperative complication especially in older people and is associated with increased mortality, morbidity and healthcare costs. There is no clear consensus which anaesthesia is associated with less incidence of POD for older patients. We aim to assess whether regional anaesthesia results in lower incidence of POD comparing with general anaesthesia (GA) among older patients undergoing hip fracture surgery.Methods and analysisRAGA-delirium is a pragmatic, multicentre, prospective, parallel grouped, randomised controlled clinical trial comparing RA or GA for hip fracture surgery. A total of 1000 patients who are 65 years or over and who are having planned hip fracture surgery in nine clinical trial centres of China will be randomised in a 1:1 ratio to receive either anaesthesia for the surgery. The primary endpoint will be the incidence of POD at day 7. The secondary endpoints will be the subtype, severity and duration of delirium, postoperative acute pain score, incidence of other postoperative non-delirium complications, quality of life and cost-effective outcomes. Randomisation will be performed at the patient level using computer-generated assignment. Outcome assessors will be blinded from intervention assignment. Assessments will be conducted before surgery, intraoperatively, postoperatively, during the hospital stay, at 30-day, 6-month and 1-year postoperative intervals.Potential impact of studyThis study will provide clinical evidence with a more robust methodology to help anaesthetists in selecting appropriate anaesthesia for older patients with high risk for POD. At the era of increasing emphasis on delirium prevention, this trial has the potential to inform the future national guideline to reduce POD.Ethics and disseminationEthical approved by the local institutional review board. Trial results will be presented at national and international academic conferences, and published in peer-reviewed journals.Trial registration numberClinicalTrials.gov (NCT02213380); pre-results.

scholarly journals Risk factors and mortality of patients undergoing hip fracture surgery: a one-year follow-up study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Pierre Huette ◽  
Osama Abou-Arab ◽  
Az-Eddine Djebara ◽  
Benjamin Terrasi ◽  
Christophe Beyls ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hip Fracture ◽  
Hip Fracture Surgery ◽  
Follow Up Study ◽  
One Year ◽  
Fracture Surgery
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