Mobility training after hip fracture: a randomised controlled trial

Objective: to compare the effects of two different exerciseprogrammes after hip fracture. Design: assessor-blinded randomised controlled trial. Setting: hospital rehabilitation units, with continued interventionat home. Subjects: 160 people with surgical fixation for hip fracturetransferred to inpatient rehabilitation. Method: in addition to other rehabilitation strategies, theintervention group received a higher dose (60 min/day) exerciseprogramme conducted whilst standing and the control group receiveda lower dose exercise programme (30 min/day) primarily conductedwhilst seated/supine. The primary outcome measures were kneeextensor muscle strength in the fractured leg and walking speed,measured at 4 and 16 weeks. Results: 150 participants (94% of those recruited) completedthe trial. There were no differences between the groups forthe two primary outcome measures. Post hoc analyses revealedincreased walking speed among those in the higher dose, weight-bearingexercise group with cognitive impairment at 4 and 16 weeks. Conclusions: there was no benefit (or harm) due to the higherdose, weight-bearing exercise programme with respect to theprimary outcome measures. However, people with hip fractureand cognitive impairment gained greater benefit from the higherdose programme than from the lower dose programme.