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The purpose of this study is to examine the effect of progressive strength training of the fractured limb in patients with hip fracture, during admittance in an acute orthopedic ward. The primary study hypothesis is that the training will reduce the strength deficit in the fractured limb in comparison with the non-fractured limb. Secondary, that patients following the intervention will present larger improvements in physical function compared to controls.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Rehabilitation without strength training | Active Comparator | Basic mobility and exercise therapy without strength training following a guideline with 12 specific exercises, progressed individually. |
|
| Rehabilitation with strength training | Experimental | Basic mobility and exercise therapy following a guideline with 12 specific exercises, progressed individually, and supplemented with progressive knee-extension strength training (10RM) of fractured limb every day during admission. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Rehabilitation with strength training | Other | Basic mobility and exercise therapy following a guideline with 12 specific exercises, progressed individually, and supplemented with progressive knee-extension strength training (10RM) of the fractured limb using ankle weight cuffs, daily during hospital stay. |
| Measure | Description | Time Frame |
|---|---|---|
| Knee-extension strength in the fractured limb in comparison with the non-fractured limb. | Maximal isometric knee-extension strength in the fractured limb in percentage of non-fractured limb. Isometric knee-extension strength will be measured using an externally fixated handheld dynamometer (Power Track II Commander; JTech Medical, Utah). A stap will be attached to the bed/chair and the patient's ankle (perpendicular to the lower leg), ensuring 90 degrees of knee flexion and an isometric contraction. The transducer will be placed under the strap at ankle level, just proximal to the malleolus, and the participant will be asked to extend the leg as forcefully as possible. Knee-extension strength will be expressed as the maximal voluntary torque per kilo body mass ([NIm]/kg), using the distance between the lateral femoral epicondyle and the center of the transducer and the body mass of each patient. The best of 4 trials for each limb will be used in analyses. The primary analysis will follow the intention-to-treat principle (last observation carried forward). | At inclusion, at postoperative day 10 and/or at discharge. |
| Measure | Description | Time Frame |
|---|---|---|
| Timed up and go test | Timed Up and Go test is assessed as early as possible during in-hospital stay and at discharge. | From inclusion to postoperative day 10 and/or discharge |
| Measure | Description | Time Frame |
|---|---|---|
| 10 meter fast speed, Cumulated Ambulation Score. | Cumulated Ambulation Score is recorded every day from inclusion to discharge. 10 meter fast speed is assessed at postoperative day 10 and/or discharge. | At discharge and during in-hospital stay. |
| Short Falls Efficacy Scale-International (Short FES-I) |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Lise Kronborg, MSc | PMR-C, Copenhagen University at Hvidovre Hospital. | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Orthopedic Surgery hvidovre hospital | Hvidovre | Copenhagen | 2650 | Denmark |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28662153 | Derived | Kronborg L, Bandholm T, Palm H, Kehlet H, Kristensen MT. Effectiveness of acute in-hospital physiotherapy with knee-extension strength training in reducing strength deficits in patients with a hip fracture: A randomised controlled trial. PLoS One. 2017 Jun 29;12(6):e0179867. doi: 10.1371/journal.pone.0179867. eCollection 2017. |
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| ID | Term |
|---|---|
| D006620 | Hip Fractures |
| ID | Term |
|---|---|
| D005264 | Femoral Fractures |
| D050723 | Fractures, Bone |
| D014947 | Wounds and Injuries |
| D025981 | Hip Injuries |
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| ID | Term |
|---|---|
| D012046 | Rehabilitation |
| D055070 | Resistance Training |
| ID | Term |
|---|---|
| D000359 | Aftercare |
| D003266 | Continuity of Patient Care |
| D005791 | Patient Care |
| D013812 | Therapeutics |
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|
| Rehabilitation without strength training | Other | Basic mobility and exercise therapy without strength training following a guideline with 12 specific exercises, progressed individually. |
|
A questionnaire evaluation of the patient's subjective concern at the moment for falling related to 7 different physical functions. Score 7-28, with maximum score expressing very high concern of falling in all 7 physical functions. |
| At discharge |
| Verbal Ranking Scale (VRS) | Evaluation of experienced hip-fracture related pain at rest and during strength training and testing. | During in-hospital stay. |
| 24-hour activity | 24-hour sit/lie and stand/walk activity measured by a ActivPAL3 activity monitor (PAL Technologies Ltd, Scotland) attached to the patient's non-fractured thigh. | From inclusion to discharge |
| D007869 |
| Leg Injuries |
| D006296 |
| Health Services |
| D005159 | Health Care Facilities Workforce and Services |
| D005081 | Exercise Therapy |
| D026741 | Physical Therapy Modalities |
| D064797 | Physical Conditioning, Human |
| D015444 | Exercise |
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |