A randomized, controlled comparison of home versus institutional rehabilitation of patients with hip fracture.
OBJECTIVE
To compare ambulation outcomes between home and institutional rehabilitation of patients with hip fracture.


METHODS
Randomized controlled clinical equivalence trial.


METHODS
The Queen Elizabeth Hospital in Hong Kong.


METHODS
Eighty-one patients with hip fracture.


METHODS
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.


METHODS
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.


CONCLUSIONS
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.
Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong. rskuisma@polyu.edu.hk
Raija
R
Kuisma
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery; D018575:Home Care Services, Hospital-Based; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D026741:Physical Therapy Modalities; D020127:Recovery of Function / Q000502:physiology; D012047:Rehabilitation Centers; D013997:Time Factors