Mobile health education program may enhance recovery for older patients with hip fractures
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Key takeaways:
- A 3-month mobile rehabilitation and education program may enhance recovery for older patients with hip fractures.
- The intervention failed to maintain effectiveness at 1 year compared with usual care.
A mobile rehabilitation and health education intervention may enhance recovery and improve physical performance for older patients with hip fractures at 3 months postoperatively, according to published data.
Rafael Prieto-Moreno, PhD, a clinical investigator at the University of Granada in Spain, and colleagues performed a multicenter, randomized controlled trial to assess the impact of mobile rehabilitation and education on patients aged 65 years and older who underwent surgery for an osteoporotic hip fracture.
Prieto-Moreno and colleagues randomly assigned 51 patients (mean age of 79.55 years) to receive a 3-month mobile rehabilitation and health education intervention and 54 patients (mean age of 80.07 years) to receive usual care. Follow-up was performed at discharge, 3 months and 1 year postoperatively. The primary outcome was physical performance, which was measured by short physical performance battery (SPPB) scores.
Researchers found the intervention group had a better mean SPPB score compared with the control group at 3 months postoperatively (7.11 points vs. 5.71 points). Prieto-Moreno and colleagues noted the difference was not maintained at 1-year follow-up.
The researchers found patients in the intervention group had fewer falls compared with the control group at both 3 months and 1 year. They also noted that no patients in the intervention group had any falls or re-fractures during the intervention sessions.
Prieto-Moreno and colleagues concluded a mobile rehabilitation and health education intervention could provide benefit to older patients after hip fracture surgery. However, they noted the intervention may depend on caregiver support and the study excluded patients with cognitive impairments.
Perspective
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Proximal femur fractures significantly impact patient function, mental health, independence and stress of family members. Mobile application-based physical therapy has gained traction in the elective arthroplasty population and may enable hip fracture patients to access virtual rehabilitation and health education resources at home. The influence of a virtual app-based rehabilitation program was investigated in this study, which was a prospective, multicenter, randomized controlled trial comparing hip fracture patients recovering with the standard home physical therapy program vs. ActiveHip+ virtual rehabilitation program for the first 3 months postoperatively.
At 3 months, virtual physical therapy was associated with improved physical performance, emotional status, pain relief and self-perceived health and family members reported less burden and depression, but these outcomes were not sustained through 1 year. The authors also point out the high frequency of falls in patients who have sustained a proximal femur fracture, with approximately one-third of patients losing their balance during the study period. This demonstrates that, as surgeons, we must not only focus on this cohort of patients in the perioperative period, but patients may benefit from continuous gait and balance training and other physical therapy modalities and education using virtual technology.
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