title: Effectiveness of task specific gait and balance exercise 4 months after hip fracture: protocol of a randomized controlled trial--the Eva-hip study.
abstract: OBJECTIVE
  Regular rehabilitation is not sufficient for regaining function after a hip fracture, and more targeted interventions for home-dwelling elderly hip-fracture patients are needed. This paper describes the protocol of a study assessing the effectiveness and cost effectiveness of a task specific progressive gait and balance exercise programme for hip-fracture patients, performed 4 months after the fracture.
  
  
  METHODS
  A single blind two-arm pragmatic randomised controlled trial was conducted with 142 hip-fracture patients randomized to a 10-week home-based exercise programme or to practice as usual 4 months following the surgery. Inclusion criteria were age >70 years and being home dwelling prior to the fracture. Exclusion criteria are life expectancy <3 months and inability to walk 10 m prior to the fracture. The content and organization of the programme was developed in collaboration between physiotherapy researchers and primary health-care physiotherapists. Participants were followed for 1 year post-surgery, evaluating short-term and long-term effects of the programme. The primary outcome is gait speed, and the secondary outcomes are spatial and temporal gait parameters, free living physical behaviour by activity monitoring, mobility performance, activities of daily living, fear of falling, cognitive function, depression and health-related quality of life. Cost-effectiveness analysis is planned.
  
  
  CONCLUSIONS
  This paper describes a task specific exercise programme aimed to improve gait and balance after a hip fracture. Inclusion started in February 2011, and the last 1-year follow-up is performed in March 2014. Broad inclusion criteria and physiotherapy-guided home-based exercises may facilitate the participation from frail patients and thereby increase the generalizability of the findings. Development and completion of the intervention within routine clinical practice will enlighten the implementation of results into clinical practice. Results may add new insight into how physiotherapy can improve gait and thereby activity and functioning in everyday life and have implications on future content and organization of physiotherapy after a hip fracture.
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Pernille
authors.initials: P
authors.lastname: Thingstad
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Kristin
authors.initials: K
authors.lastname: Taraldsen
authors.affiliation: Department of Public Health and Community Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Gunhild
authors.initials: G
authors.lastname: Hagen
authors.affiliation: Unit for Physiotherapy Services, the Municipality of Trondheim, Trondheim, Norway.
authors.forename: Sylvi
authors.initials: S
authors.lastname: Sand
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Geriatrics, St Olav University Hospital, Trondheim, Norway.
authors.forename: Ingvild
authors.initials: I
authors.lastname: Saltvedt
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Geriatrics, St Olav University Hospital, Trondheim, Norway.
authors.forename: Olav
authors.initials: O
authors.lastname: Sletvold
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Clinical Services, St. Olav University Hospital, Trondheim, Norway.
authors.forename: Jorunn L
authors.initials: JL
authors.lastname: Helbostad
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006620:Hip Fractures / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities / Q000191:economics; D004856:Postural Balance / Q000502:physiology*; D011788:Quality of Life / Q000523:psychology; D016037:Single-Blind Method; D016896:Treatment Outcome
keywords: accelerometry; ageing; exercise; gait; hip fracture