title: A randomised trial of weight-bearing versus non-weight-bearing exercise for improving physical ability in inpatients after hip fracture.
abstract: The purpose of this study was to assess the effects of weight-bearing and non-weight-bearing exercise on strength, balance, gait and functional performance among older inpatients following hip fracture. Eighty people (mean age 81 years, SD 8) undergoing inpatient rehabilitation after fall-related hip fracture were randomised to receive two-week programs of either weight-bearing or non-weight-bearing exercise prescribed by a physiotherapist. Both groups improved markedly (in the order of 50%) on measures of physical ability. Overall there was little difference between groups in the extent of improvement, however post hoc testing identified some additional strength benefits for the non-weight-bearing group--non-affected leg hip flexion mean difference in extent of improvement was 9.3 N (95% CI 3.7 to 15.0), non-affected leg hip abduction mean difference in extent of improvement was 6.5 N (95% CI 0.1 to 12.9). There were also additional functional benefits for the weight-bearing group--improved ability to complete a lateral step-up on the affected leg with nil or one hand supports (OR 3.4, 95% CI 1.1 to 12.3) and the need for less supportive walking aids (p = 0.045). Weight-bearing and non-weight-bearing exercise programs produce similar effects on strength, balance, gait and functional performance among inpatients soon after hip fracture.
authors.affiliation: Prince of Wales Medical Research Institute, University of New South Wales, Randwick, New South Wales 2031. c.sherrington@unsw.edu.au
authors.forename: Catherine
authors.initials: C
authors.lastname: Sherrington
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
authors.forename: Robert D
authors.initials: RD
authors.lastname: Herbert
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005684:Gait / Q000502:physiology; D006620:Hip Fractures / Q000534:rehabilitation*; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D005082:Physical Exertion / Q000502:physiology; D026741:Physical Therapy Modalities / Q000379:methods*; D004856:Postural Balance / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D013647:Task Performance and Analysis; D016896:Treatment Outcome; D016474:Weight-Bearing / Q000502:physiology