Effects of Tele-Rehabilitation Compared with Home-Based in-Person Rehabilitation for Older Adult's Function after Hip Fracture

Mariana Ortiz-Piña, Pablo Molina-Garcia, Pedro Femia, Maureen C Ashe, Lydia Martín-Martín, Susana Salazar-Graván, Zeus Salas-Fariña, Rafael Prieto-Moreno, Yolanda Castellote-Caballero, Fernando Estevez-Lopez, Patrocinio Ariza-Vega, Mariana Ortiz-Piña, Pablo Molina-Garcia, Pedro Femia, Maureen C Ashe, Lydia Martín-Martín, Susana Salazar-Graván, Zeus Salas-Fariña, Rafael Prieto-Moreno, Yolanda Castellote-Caballero, Fernando Estevez-Lopez, Patrocinio Ariza-Vega

Abstract

This study aimed to examine the effect of a multidisciplinary tele-rehabilitation program on functional recovery of older adults with hip fracture compared with home-based in-person rehabilitation. In this single-blinded, non-randomized clinical trial, we included older with hip fracture. The tele-rehabilitation group received a 12-week tele-rehabilitation program (supervised by their family caregivers). The control group received the usual postoperative rehabilitation provided by the Andalusian health system (Spain). The primary outcome was the patient-reported functional status assessed with the Functional Independence Measure. We also measured performance-based functional recovery using the Timed Up and Go Test and Short Physical Performance Battery. We performed both a per-protocol (62 participants; 28 tele-rehabilitation and 34 control groups) and an intention-to-treat analysis (71 participants; 35 tele-rehabilitation and 36 control groups). Participants who used the tele-rehabilitation program had higher Functional Independence Measure scores (high effect size: 0.98 Cohen's d; p < 0.001) and better performance in the Timed Up and Go Test (medium effect size: 0.63 Cohen's d; p = 0.025) compared with the control group. Differences between groups post-intervention were not statistically significant in the Short Physical Performance Battery. The tele-rehabilitation intervention proposed in this study is a valuable treatment option in the recovery process for older adults with hip fracture. ClinicalTrials.gov Identifier: NCT02968589.

Keywords: activities of daily living; exercise; mobility; rehabilitation.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure A1
Figure A1
Effect sizes of the ActiveHip project on functional independence and physical performance in the intention-to-treat analysis.
Figure 1
Figure 1
Flowchart with the inclusion/exclusion of participants.
Figure 2
Figure 2
Effect sizes of the ActiveHip project on functional independence and physical performance in the per-protocol analysis.

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