This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Over 325,000 hip fractures occur in the US each year, with the cost to patients, families and the health care system estimated at between 14 and 20 billion dollars annually. (1-2) Despite improvements in medical management, significant residual disability remains in older persons post hip fracture.(3) The current practice goal for discharge from medical management at 2-3 months post surgery is independent, safe household ambulation.(4) Hip fracture-acquired dependency in functional activities of daily living persists well beyond that point: 20% of patients need help putting on pants, 50% need assistance to walk, and 90% need assistance to climb stairs 12 months after hip fracture.(5-6) These figures indicate that the current standard Medicare-reimbursed rehabilitation therapy fails to return a large proportion of patients to pre-fracture levels of function. Thus, while hip fractures are common and lead to extended disability under usual care management strategies, there is a paucity of evidence to justify extending medical management beyond the current standard in persons post-fracture.This pilot will evaluate a 16-week, supervised multi-component intervention that is introduced as soon as the patient completes usual care (typically within two months of the fracture). The intervention has been designed to address four relevant precursors to community ambulation using stress overload and specificity of training principles. The effect of the intervention on impairments, functional limitations, and disability also will be examined.
Showing the most recent 10 out of 638 publications
