• Johanna Edgren, Anu Salpakoski, Sanna E Sihvonen, Erja Portegijs, Mauri Kallinen, Marja Arkela, Pirkko Jäntti, Jukka Vanhatalo, Mika Pekkonen, Taina Rantanen, Ari Heinonen, and Sarianna Sipilä.
• Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
• J Am Med Dir Assoc. 2015 Apr 1; 16 (4): 350.e1-7.

ObjectiveFewer than half of the patients with hip fracture will regain the prefracture level of physical functioning. This secondary analysis of a randomized controlled trial investigated the effects of a multicomponent home-based rehabilitation program (ProMo) on physical disability after hip fracture.DesignRandomized, controlled, parallel-group trial.SettingRehabilitation in participants' homes; measurements in university-based laboratory and local hospital.ParticipantsPopulation-based clinical sample of community-dwelling people older than 60 years (n = 81) operated for hip fracture were randomized into intervention and control groups.InterventionThe year-long intervention aimed at restoring mobility. It included evaluation and modification of environmental hazards, guidance for safe walking, pain management, home exercise, physical activity counseling, and standard care.MeasurementsPhysical disability was assessed by a questionnaire at baseline, and 3, 6, and 12 months thereafter. Sum scores were computed for basic (ADLs) and instrumental activities of daily living (IADLs). A higher score indicated more difficulty. GEE models were constructed to analyze the effect of the intervention.ResultsIn the intention-to-treat analysis, no intervention effect was observed for sum scores. For the single disability items, borderline significant positive effects were observed for preparing food and handling medication (interaction P = .061 and P = .061, respectively). In the per-protocol analysis, the mean differences between groups were -0.4 points (SE 0.5), -1.7 (0.7), and -1.2 (0.7) at 3, 6, and 12 months for ADLs and -1.0 (1.2), -3.2 (1.5), and -2.5 (1.4) for IADLs, correspondingly.ConclusionThe current analyses suggest that home-based rehabilitation may reduce disability among older people after hip fracture. The present results need to be confirmed in a study with larger sample size. Potentially a more task-oriented rehabilitation approach might gain more benefits. Current Controlled Trials (ISRCTN53680197).Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

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