A comparative study of organized class-based exercise programs versus individual home-based exercise programs for elderly patients following hip surgery.
OBJECTIVE
To evaluate and compare the effectiveness of supervised and non-supervised exercise programs for improving health and rehabilitation outcomes for elderly persons following hip surgery.


METHODS
Prospective, descriptive and quantitative study involving two groups: The class-based program (group A, n = 34: 21 females, 13 males, mean age 79.2 years +/- 5.23) was directed and administered in the outpatient clinic, and a home-based program (group B, n = 29, 17 females, 12 males, mean age 80.3 years +/- 5.74) which administered in the patient's home. Sixty three elderly patients began at a period of 2 weeks post hip surgery for open reduction with internal fixation. The training period took place for 14 consecutive weeks. The main outcome measures include results from physical performance test, functional reach test and short form-36 health survey questionnaire.


RESULTS
Fifty five patients completed the exercise program. No significant difference according to gender or Body Mass Index was found between the groups. At the conclusion of 14 weeks of exercise training both groups demonstrated improvement in physical function. However, only 4 of 6 total tasks of a physical performance test were improved in the home-based group compared to improvement in all 6 tasks for the class-based group. The SF-36 scores and the functional reach test indicated that the class-based subjects also presented significant gains in contrast to no significant changes in the home exercise group.


CONCLUSIONS
Both groups demonstrated improvement in a number of issues. However, there appears to be more positive health outcomes presented by the participants in the supervised/class-based group when compared to the non-supervised/home-based group. And therefore, patients may select to participate to either a home-based or class-based regime. The clinical relevance is the significant of the necessity for close supervision by a professional therapist. In addition, the results could have some political and economical implications on the healthcare system.
Carmeli
Eli
E
Department of Physical Therapy, Sackler Faculty of Medicine, Stanley Steyer School of Health Professions, Tel Aviv University, Ramat Aviv, Israel. elie@post.tau.ac.il
Sheklow
Sandford L
SL
Coleman
Raymond
R
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics; D005081:Exercise Therapy / Q000191:economics / Q000379:methods*; D005260:Female; D005593:Fracture Fixation, Internal / Q000534:rehabilitation*; D006620:Hip Fractures / Q000534:rehabilitation* / Q000601:surgery*; D018575:Home Care Services, Hospital-Based; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010353:Patient Education as Topic; D011446:Prospective Studies; D012648:Self Care; D016896:Treatment Outcome