title: Physical behavior and function early after hip fracture surgery in patients receiving comprehensive geriatric care or orthopedic care--a randomized controlled trial.
abstract: BACKGROUND
  This study is a part of the randomized controlled trial, the Trondheim Hip Fracture Trial, and it compared physical behavior and function during the first postoperative days for hip fracture patients managed with comprehensive geriatric care (CGC) with those managed with orthopedic care (OC).
  
  
  METHODS
  Treatment comprised CGC with particular focus on mobilization, or OC. A total of 397 hip fracture patients, age 70 years or older, home dwelling, and able to walk 10 m before the fracture, were included. Primary outcome was measurement of upright time (standing and walking) recorded for 24 hours the fourth day postsurgery by a body-worn accelerometer-based activity monitor. Secondary outcomes were number of upright events on Day 4, need for assistance in ambulation measured by the Cumulated Ambulation score on Days 1-3, and lower limb function measured by the Short Physical Performance Battery on Day 5 postsurgery.
  
  
  RESULTS
  A total of 317 (CGC n = 175, OC n = 142) participants wore the activity monitor for a 24-hour period. CGC participants had significantly more upright time (mean 57.6 vs 45.1 min, p = .016), higher number of upright events (p = .005) and better Short Physical Performance Battery scores (p = .002), than the OC participants. Cumulated Ambulation score did not differ between groups (p = .234).
  
  
  CONCLUSIONS
  When treated with CGC, compared with OC, older persons suffering a hip fracture spent more time in upright, had more upright events, and had better lower limb function early after surgery despite no difference in their need for assistance during ambulation.
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway. kristin.taraldsen@ntnu.no.
authors.forename: Kristin
authors.initials: K
authors.lastname: Taraldsen
authors.forename: Olav
authors.initials: O
authors.lastname: Sletvold
authors.forename: Pernille
authors.initials: P
authors.lastname: Thingstad
authors.forename: Ingvild
authors.initials: I
authors.lastname: Saltvedt
authors.forename: Malcolm H
authors.initials: MH
authors.lastname: Granat
authors.forename: Stian
authors.initials: S
authors.lastname: Lydersen
authors.forename: Jorunn L
authors.initials: JL
authors.lastname: Helbostad
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057189:Checklist; D002985:Clinical Protocols; D004434:Early Ambulation; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation; D009043:Motor Activity / Q000502:physiology*; D010347:Patient Care Planning; D010348:Patient Care Team; D011182:Postoperative Care; D011187:Posture / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology
keywords: Geriatric assessment; Hip fracture; Physical activity.