TY - JOUR
T1 - Rehabilitation for life
T2 - the effect on physical function of rehabilitation and care in older adults after hip fracture—study protocol for a cluster-randomised stepped-wedge trial
AU - Ipsen, Jonas Ammundsen
AU - Pedersen, Lars T.
AU - Viberg, Bjarke
AU - Nørgaard, Birgitte
AU - Suetta, Charlotte
AU - Bruun, Inge H.
N1 - Preprint published 20 Sep, 2021
The study is approved by the Regional Scientific Ethics Committees of Southern Denmark (S-20200070) and the Danish Data Protection Agency (20-21854). Clinical Trial Identifier (NCT04424186) https://clinicaltrials.gov/ct2/show/NCT04424186.
PY - 2022/5/7
Y1 - 2022/5/7
N2 - Background: A hip fracture is a serious event for older adults, given that approximately 50% do not regain their habitual level of physical function, and the mortality rate is high, as is the number of readmissions. The gap in healthcare delivery, as separated into two financial and self-governing sectors, might be a contributing cause of inferior rehabilitation and care for these patients. Therefore, we aim to assess the effect of continuous and progressive rehabilitation and care across sectors for older adults after hip fracture.Methods/design: The project is designed as a stepped-wedge cluster-randomised controlled trial. The study population of patients are older adults 65 years of age and above discharged after a hip fracture and healthcare professionals in primary and secondary care (municipalities and hospitals). In addition, health care professionals from different sectors (hospital and municipalities) will be engaged in the empowerment-orientated praxis, through a workshop for health care professionals with knowledge sharing to the older adults using a digital health application (app). The rehabilitation intervention consists of 12 weeks progressive resistance exercises initiated 1-2 days after discharge. To improve communication across sectors, a videoconference involving the patient and physiotherapists from both sectors, will be conducted.At Day 3 after discharge, an outreach nurse performs a thorough assessment including measurement of vital signs. A hotline to the hospital for medical advice is a part of the intervention. The intervention is delivered as an add-on to the usual rehabilitation and care, and it involves one regional hospital and the municipalities within the catchment area of the hospital.The primary outcome is a Timed Up and Go test eight weeks post-surgeryDiscussion: Using a stepped-wedge design, the intervention will be assessed as well as implemented in hospital and municipalities, hopefully for the benefit of older adults after hip fracture. Furthermore, the collaboration between the sectors is expected to improve.
AB - Background: A hip fracture is a serious event for older adults, given that approximately 50% do not regain their habitual level of physical function, and the mortality rate is high, as is the number of readmissions. The gap in healthcare delivery, as separated into two financial and self-governing sectors, might be a contributing cause of inferior rehabilitation and care for these patients. Therefore, we aim to assess the effect of continuous and progressive rehabilitation and care across sectors for older adults after hip fracture.Methods/design: The project is designed as a stepped-wedge cluster-randomised controlled trial. The study population of patients are older adults 65 years of age and above discharged after a hip fracture and healthcare professionals in primary and secondary care (municipalities and hospitals). In addition, health care professionals from different sectors (hospital and municipalities) will be engaged in the empowerment-orientated praxis, through a workshop for health care professionals with knowledge sharing to the older adults using a digital health application (app). The rehabilitation intervention consists of 12 weeks progressive resistance exercises initiated 1-2 days after discharge. To improve communication across sectors, a videoconference involving the patient and physiotherapists from both sectors, will be conducted.At Day 3 after discharge, an outreach nurse performs a thorough assessment including measurement of vital signs. A hotline to the hospital for medical advice is a part of the intervention. The intervention is delivered as an add-on to the usual rehabilitation and care, and it involves one regional hospital and the municipalities within the catchment area of the hospital.The primary outcome is a Timed Up and Go test eight weeks post-surgeryDiscussion: Using a stepped-wedge design, the intervention will be assessed as well as implemented in hospital and municipalities, hopefully for the benefit of older adults after hip fracture. Furthermore, the collaboration between the sectors is expected to improve.
KW - Between sectors
KW - Care
KW - Empowerment
KW - Hip fracture
KW - Physical function
KW - Rehabilitation
KW - Stepped-wedge cluster randomised controlled trial
KW - Humans
KW - Patient Discharge
KW - Hip Fractures/diagnosis
KW - Randomized Controlled Trials as Topic
KW - Time and Motion Studies
KW - Aged
KW - Exercise Therapy/methods
KW - Postural Balance
U2 - 10.1186/s13063-022-06321-w
DO - 10.1186/s13063-022-06321-w
M3 - Journal article
C2 - 35526010
SN - 1745-6215
VL - 23
JO - Trials
JF - Trials
M1 - 375
ER -