Long-term exercise training improved functioning among older adults after hip fracture operation
Hip fracture is a major trauma in an older adult’s life. Common consequences after hip fractures include decreased functional capacity and health-related quality of life, along with increased mortality and use and costs of healthcare and social services. Older adults with hip fractures need good care and rehabilitation, also after they are discharged and return home. Exercise training is an important part of an effective rehabilitation.
The primary aim of Soukkio’s dissertation was to examine whether a 12-month physiotherapist-supervised, home-based exercise program decreased the number of overnight stays in hospitals or in healthcare center wards or decreased the need for 24-hour nursing home care over a 24-month period among patients who had received a hip fracture operation.
The study included 121 home-dwelling older adults from South Karelia, Finland, who had undergone a hip fracture operation. Their mean age was 81 years, 75% were women, and 61% had a femoral neck fracture.
The participants were randomized into a 12-month, home-based exercise group, and a usual care group. The home-based exercise group had 60 minutes of guided exercise sessions twice a week, focusing mainly on training lower-leg strength and balance abilities. The usual care group continued their life as usual.
“Contrary to expectations, the home-based exercise training did not increase the number of days lived at home or decrease mortality over 24 months,” Soukkio states.
In her dissertation, Soukkio also studied the effects of home-based exercise training on the use and costs of healthcare and social services, functioning, and HRQoL. The intervention improved functional independence, instrumental activities of daily life and physical performance more than usual care over 12 months. However, there was no between-group difference in health-related quality of life during the same period. Furthermore, the HRQoL remained below the reference population level in both groups over 12 months.
Over 12 months, the costs of healthcare and social services were greater in the home-based exercise group, but this difference was not seen over 24 months.
“The 12-month supervised exercise program was most cost-effective when targeted at hip fracture patients with lower functional independence at the time of being discharged home from hospital,” says Soukkio.
“As a conclusion, a long-term supervised, home-based physical exercise program after hip fractures is effective in improving physical functioning over 12 months without increasing total healthcare and social service costs compared to usual care over 24 months. Moreover, it seems that to increase HRQoL, a more versatile intervention would be needed.”
This dissertation is based on data from the randomized controlled HIP fracture and FRAilty (HIPFRA) trial (ClinicalTrials.gov, NCT02305433).
Paula dzܰ쾱’s dissertation, Days Lived at Home, Use and Costs of Healthcare and Social Services, Functioning, and Health-Related Quality of Life After Hip Fracture: Effects of a 12-Month Home-Based Exercise Intervention, is to be publicly discussed, by the permission of the Faculty of Sport and Health Sciences of the Ģֱ in the Liikunta building, auditorium L 302, on 25 October 2024 at 12 noon.
The opponent of the thesis is Docent Kirsti Uusi-Rasi from the University of Tampere, and Professor Sarianna Sipilä is the custos. The public discussion is to be held in Finnish and it can be watched remotely: .
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Paula Soukkio, MSc
Wellbeing services county of South Karelia
paula.soukkio@ekhva.fi