Tele-rehabilitation Intervention for People Post Hip Fracture - Pilot Study

Effectiveness of a Tele-rehabilitation Intervention to Improve Performance and Reduce Morbidity for People Post Hip Fracture - Pilot Study

Most surviving hip-fracture patients experience reduced mobility and lose their functional ability, which increases the risk of complications and rehospitalization. Post-discharge transitional programs to reduce readmissions have shown some success. Telerehabilitation refers to the use of technologies to provide rehabilitation services to people in their homes. Considering the need for long-term follow-up care for people with hip fracture, in-home telerehabilitation could increase independence, decrease hospital stays and reduce the burden for caregivers.

The purpose of the pilot study is to examine the feasibility and acceptability of the research methods evaluating telerehabilitation with adults who have experienced hip fracture, in preparation for a larger randomized controlled study. A one-group (N=6) pre-test/post-test design is currently being constructed. Results of the pilot study will be used to determine what adaptations to the design may be required to ensure successful implementation. Recruitment, retention and attendance rates, as well as percentages completing the outcome measures, will be examined to plan the time frame of the main trial.

The intervention will include 10 videoconferencing sessions from an occupational therapist in the presence of the primary caregiver. Each session will be utilized to guide the participants to achieve their self-identified goals, focusing on problem-solving for daily life situations and on the ability to implement the discussed strategies for a variety of activities.

Inclusion Criteria:

• Older adults (age ≥60 years)
• post hip fracture - discharged from the inpatient rehabilitation unit of Herzog Hospital, Jerusalem, between January 2017 and December 2017.
• Discharge from rehabilitation to a non-institutionalized setting.
• broadband or Wi-Fi in their home and must be able to operate an iPad independently.
• FIM>90 at discharge.
• Has a designated caregiver (a close friend, family member, or support worker) aged over 18, and a Hebrew, English or Arabic speaker, who will agree to cooperate in the research.

Exclusion Criteria:

• Aphasia.
• cognitive impairment (Montreal Cognitive Assessment scores : MOCA<19 or MMSE<21).
• degenerative neurological diagnoses.
• current major depressive or psychotic disorder.
• other acute or chronic health condition that will influence their ability to participate in the study.