title: Physical Activity After a Hip Fracture: Effect of a Multicomponent Home-Based Rehabilitation Program-A Secondary Analysis of a Randomized Controlled Trial.
abstract: To investigate the effect of a yearlong multicomponent rehabilitation program on the level of physical activity (PA) and the maintenance of the level of PA over 1-year follow-up among older people recovering from a recent hip fracture.
  
  
  
  Secondary analysis of a randomized, controlled, parallel-group trial.
  
  
  
  Home-based rehabilitation; measurements in university laboratory.
  
  
  
  Community-dwelling people (N=81) aged ≥60 years recovering from a hip fracture. Participants were randomly assigned to an intervention (n=40) or a control (n=41) group, on average, 42±23 days after discharge from the hospital.
  
  
  
  A yearlong intervention included evaluation and modification of environmental hazards, guidance for safe walking, nonpharmacologic pain management, a progressive home exercise program, PA counseling, and standard care.
  
  
  
  The outcome was the level of PA, which was assessed with the questionnaire (a modified Grimby scale) at baseline, and 3, 6, 12, and 24 months after baseline. Three PA categories were defined: inactivity, light PA, and moderate to heavy PA. Physical function was assessed using the Short Physical Performance Battery (SPPB) at baseline. The effects of the intervention were analyzed with generalized estimating equations.
  
  
  
  In the intervention group, a significant increase was observed in the level of PA after the intervention (interaction P=.005) and after 1-year follow-up (P=.021) compared with the standard care only. The benefit was particularly evident among the participants with a baseline SPPB score of ≥7 (interaction P<.001).
  
  
  
  The 12-month individualized multicomponent rehabilitation program increased PA among older patients with hip fracture. The increase was found to be maintained at the 1-year follow-up.
authors.affiliation: Gerontogy Research Center, Unit of Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland; GeroCenter Foundation for Aging Research and Development, Jyvaskyla, Finland. Electronic address: katri.m.turunen@jyu.fi.
authors.forename: Katri
authors.initials: K
authors.lastname: Turunen
authors.affiliation: Research and Development, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland.
authors.forename: Anu
authors.initials: A
authors.lastname: Salpakoski
authors.affiliation: Gerontogy Research Center, Unit of Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland.
authors.forename: Johanna
authors.initials: J
authors.lastname: Edgren
authors.affiliation: Gerontogy Research Center, Unit of Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Törmäkangas
authors.affiliation: Department of Physiotherapy, Central Hospital of Central Finland, Jyvaskyla, Finland.
authors.forename: Marja
authors.initials: M
authors.lastname: Arkela
authors.affiliation: Department of Medical Rehabilitation, Oulu University Hospital, Oulu, Finland; Center for Life Course Epidemiology Research, University of Oulu, Oulu, Finland.
authors.forename: Mauri
authors.initials: M
authors.lastname: Kallinen
authors.affiliation: Department of Orthopedics and Traumatology, Central Hospital of Central Finland, Jyvaskyla, Finland.
authors.forename: Maija
authors.initials: M
authors.lastname: Pesola
authors.affiliation: Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland; School of Pharmacy, University of Eastern Finland, Kuopio, Finland.
authors.forename: Sirpa
authors.initials: S
authors.lastname: Hartikainen
authors.affiliation: Gerontogy Research Center, Unit of Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland; GeroCenter Foundation for Aging Research and Development, Jyvaskyla, Finland; Research & Education, Central Hospital of Central Finland, Jyvaskyla, Finland.
authors.forename: Riku
authors.initials: R
authors.lastname: Nikander
authors.affiliation: Gerontogy Research Center, Unit of Health Sciences, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland.
authors.forename: Sarianna
authors.initials: S
authors.lastname: Sipilä
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003376:Counseling; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006620:Hip Fractures / Q000534:rehabilitation* / Q000601:surgery; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D010349:Patient Compliance; D016138:Walking
keywords: Exercise; Hip fractures; Rehabilitation