152.
Feasibility and effect of a progressive strength-training program in
older community-dwelling patients commenced shortly after hip fracture
surgery.
Jan Arnholtz Overgaard, Morten Tange Kristensen
Department of Rehabilitation Lolland Community, Denmark; Department of
Physical Therapy and Orthopedic Surgery, Copenhagen University Hospital at
Hvidovre, Denmark
Background:
Having a hip fracture is associated with loss of fractured lower
limb strength of more than 50% within few weeks of surgery, and poor return
of functional mobility. Still, there is a lack of knowledge of the effect of
different training programmes.
Purpose / Aim of Study:
To investigate the feasibility of progressive strength-
training program commenced shortly after hip fracture surgery, and to report
functional adaptations, including details of specific weight loads, and if hip
fracture related pain influenced testing, and strength training.
Materials and Methods:
Thirty-one community-dwelling patients at a mean
(
SD) age of 77.9 (9) years (26 women), who commenced a 6-week
rehabilitation program, twice weekly, at a mean of 17.5 (5.7) days after hip
fracture surgery. The program included, balance, functional- and progressive
fractured knee-extension and bilateral leg press strength training, with relative
loads of 15- to 10 repetitions maximum (three sets per session).
Findings / Results:
Significant (P<0.001) improvements of 67% for fractured
limb knee-extension strength, 59% for New Mobility Score, 61% for 6 minutes
walk test (from 201 to 323 meters), and 10% for SF-36 were seen after
rehabilitation. Knee-extension strength deficits of the fractured limb changed
from 40% of the non-fractured limb to 17% after rehabilitation. Weight loads
increased progressively (P<0.001) during fractured knee-extension training,
while hip fractured related pain was reduced (P=0.007).
Conclusions:
Progressive 6-week strength training initiated shortly after hip
fracture is feasible and seems effective in reducing strength deficits and
improving functional performances. Hip-pain was of minor influence.
Nevertheless, a fractured knee-extension strength deficit of 17% remained.
Thus, an extended or more intensive program focused at the fractured limb
seems necessary.
