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A randomized, controlled comparison of home versus institutional rehabilitation of patients with hip fracture
1Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong. rskuisma@polyu.edu.hk
Objective:
To compare ambulation outcomes between home and institutional rehabilitation of patients with hip fracture.
Design:
Randomized controlled clinical equivalence trial.
Setting:
The Queen Elizabeth Hospital in Hong Kong.
Subjects:
Eighty-one patients with hip fracture.
Intervention:
Study group patients (40) were discharged directly home from the acute hospital and visited by a physiotherapist an average of 4.6 times. The control group subjects (41) were discharged to a rehabilitation centre for further treatment lasting on average 36.2 days (SD 14.6) and they received physiotherapy daily.
Main Outcome Measures:
Ambulation ability measured on a categorical scale.
Results:
The mean age of the subjects was 75 years (SD 8.3 years). Females comprised 60% of all the subjects and majority were retired or home makers. Both groups of patients improved in their ambulation ability during their rehabilitation period but neither group achieved their pre-ambulatory status by the time of completion of the study. The study group achieved significantly higher ambulation scores (p < 0.05) for community and household ambulation compared with the control group by the end of the study, a year after operation.
Conclusion:
Five visits by a physiotherapist in the patient's home after discharge from an acute hospital after surgical treatment for hip fracture yielded better results in ambulation ability than one month of conventional institution-based rehabilitation.
