title: The long-term effect of being treated in a geriatric ward compared to an orthopaedic ward on six measures of free-living physical behavior 4 and 12 months after a hip fracture - a randomised controlled trial.
abstract: BACKGROUND
  This study is part of the Trondheim Hip Fracture Trial, where we compared free-living physical behavior in daily life 4 and 12 months following hip surgery for patients managed with comprehensive geriatric care (CGC) in a geriatric ward with those managed with orthopedic care (OC) in an orthopedic ward.
  
  
  METHODS
  This is a single centre, prospective, randomized controlled trial. 397 hip fracture patients were randomized to CGC (n = 199) or OC (n = 198) in the Emergency Department with follow-up assessments performed four and 12 months post-surgery. Outcomes were mean upright time, number and length of upright events recorded continuously for four days at four and 12 months post-surgery by an accelerometer-based activity monitor. Missing data were handled by multiple imputation and group differences assessed by linear regression with adjustments for gender, age and fracture type.
  
  
  RESULTS
  There were no group differences in participants' pre-fracture characteristics. Estimated group difference in favor of CGC in upright time at 4 months was 34.6 min (17.4 %, CI 9.6 to 59.6, p = .007) and at 12 months, 27.7 min (13.9 %, CI 3.5 to 51.8, p = .025). Average and maximum length of upright events was longer in the CGC (p's < .042). No group difference was found for number of upright events (p's > .452).
  
  
  CONCLUSIONS
  Participants treated with CGC during the hospital stay improved free-living physical behavior more than those treated with OC both 4 and 12 months after surgery, with more time and longer periods spent in upright. Results support findings from the same study for functional outcomes, and demonstrate that CGC impacts daily life as long as one year after surgery.
  
  
  BACKGROUND
  ClinicalTrials.gov, NCT00667914 , April 18, 2008.
authors.affiliation: Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and technology, N-7491, Trondheim, Norway. kristin.taraldsen@ntnu.no.
authors.forename: Kristin
authors.initials: K
authors.lastname: Taraldsen
authors.affiliation: Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and technology, N-7491, Trondheim, Norway. pernille.thingstad@ntnu.no.
authors.forename: Pernille
authors.initials: P
authors.lastname: Thingstad
authors.affiliation: Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and technology, N-7491, Trondheim, Norway. olav.sletvold@ntnu.no.|Department of Geriatrics, St. Olavs Hospital, University Hospital of Trondheim, NO-7006, Trondheim, Norway. olav.sletvold@ntnu.no.
authors.forename: Olav
authors.initials: O
authors.lastname: Sletvold
authors.affiliation: Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and technology, N-7491, Trondheim, Norway. ingvild.saltvedt@ntnu.no.|Department of Geriatrics, St. Olavs Hospital, University Hospital of Trondheim, NO-7006, Trondheim, Norway. ingvild.saltvedt@ntnu.no.
authors.forename: Ingvild
authors.initials: I
authors.lastname: Saltvedt
authors.affiliation: Regional Centre for Child and Youth Mental health and Child Welfare, Norwegian University of Science and technology, N-7491, Trondheim, Norway. stian.lydersen@ntnu.no.
authors.forename: Stian
authors.initials: S
authors.lastname: Lydersen
authors.affiliation: School of Health Sciences, University of Salford, Manchester, M5 4WT, UK. m.h.granat@salford.ac.uk.
authors.forename: Malcolm H
authors.initials: MH
authors.lastname: Granat
authors.affiliation: School of Health and Life Science, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, Scotland, UK. Sebastien.Chastin@gcu.ac.uk.
authors.forename: Sebastien
authors.initials: S
authors.lastname: Chastin
authors.affiliation: Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and technology, N-7491, Trondheim, Norway. jorunn.helbostad@ntnu.no.|Clinic for Clinical Services, St. Olavs Hospital, University Hospital of Trondheim, NO-7006, Trondheim, Norway. jorunn.helbostad@ntnu.no.
authors.forename: Jorunn L
authors.initials: JL
authors.lastname: Helbostad
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects / Q000379:methods; D015577:Geriatric Assessment; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006620:Hip Fractures / Q000601:surgery / Q000628:therapy; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D009985:Orthopedics / Q000379:methods*; D017063:Outcome Assessment, Health Care; D010346:Patient Care Management / Q000379:methods / Q000706:statistics & numerical data; D011184:Postoperative Period; D011446:Prospective Studies; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*