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Related Experiment Video

Updated: Jul 18, 2025

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Multicomponent Home-based Physical Therapy Versus Usual Care for Recovery After Hip Fracture.

Nikhil K Prasad1, Rashmita Bajracharya2, Marniker Wijesinha2

  • 1Department of Surgery, University of Maryland Medical Center, Baltimore, MD; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD.

Archives of Physical Medicine and Rehabilitation
|August 23, 2023
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Summary

Home-based physical therapy improves functional recovery after hip fracture. Two multi-component interventions (PUSH and PULSE) showed greater improvements in the Short Physical Performance Battery (SPPB) and gait speed compared to usual care.

Keywords:
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Area of Science:

  • Gerontology
  • Rehabilitation Medicine
  • Orthopedics

Background:

  • Hip fracture significantly impacts functional recovery and independence in older adults.
  • Usual care often results in suboptimal long-term functional outcomes.
  • Home-based physical therapy offers a potential avenue to enhance post-fracture rehabilitation.

Purpose of the Study:

  • To compare the effectiveness of two home-based multi-component physical therapy interventions against usual care for functional recovery after hip fracture.
  • To quantify the impact of 16-week interventions on physical performance and mobility.

Main Methods:

  • A cross-study comparison utilizing data from the Community Ambulation Project (CAP) and Baltimore Hip Studies-seventh cohort (BHS-7).
  • Participants included hip fracture patients (N=549) receiving either specific (PUSH) or non-specific (PULSE) multi-component physical therapy or usual care (BHS-7).
  • Functional recovery was assessed using the Short Physical Performance Battery (SPPB) and gait speed at multiple time points post-fracture.

Main Results:

  • Participants in both PUSH and PULSE groups demonstrated significantly greater improvements in SPPB scores compared to the BHS-7 usual care group (0.7 and 0.9 points, respectively).
  • Gait speed also showed significant improvements in the PUSH and PULSE groups compared to BHS-7 (0.08 m/s and 0.06 m/s, respectively).
  • Baseline characteristics differed between the harmonized samples, but the interventions still yielded positive results.

Conclusions:

  • Home-based multi-component physical therapy programs are associated with enhanced functional recovery after hip fracture.
  • These interventions demonstrate superior outcomes in physical performance and mobility compared to usual care.
  • The findings support the integration of structured home-based physical therapy into post-hip fracture care pathways.