Enhancing Rehabilitation after Hip Fracture and Total Hip Arthroplasty

Overview

Status: Enrolling by invitation
Keywords: hip fracture , rehabilitation , eccentric , weightbearing , therapy , hip replacement , physical performance , strength , balance , fall
IRB Number: 00062639
Specialty: Physical Therapy
Sub Specialties:

Brief Summary

The purpose of this pilot project is to test whether a home-based eccentrically-biased exercise protocol during the 3-6 month period following hip fracture can mitigate the impairments typically seen in this needy population.  Further, we will characterize changes in muscle composition following hip fracture.  The specific aims of this project are as follows:

Aim 1.  Determine the impact of 3 months of MOVE, initiated at 3 months after hip fracture on physical function.

  • Hypothesis: MOVE will have a greater effect on physical function (as measured by  modified PPT score)  than usual care at 3 and 6 months post-surgery
  • Hypothesis: MOVE will have a greater effect on physical function (as measured by 6-minute walk performance) than usual care at 3 and 6 months post-surgery.

Aim 2.  Determine the impact of 3 months of MOVE, initiated at 3 months after hip fracture on muscle quality (force/unit area).

  • Hypothesis: MOVE will improve muscle quality (force/unit area of muscle) between 3 and 6 months post-surgery to a greater extent than usual care

Exploratory Aim.  Characterize muscle size and composition, and the balance between anabolic and catabolic cellular signaling in the muscle 3 months following hip fracture and following 3 months of MOVE or usual care.

Exploratory Aim.  Describe costs linked to recovery among hip fracture recipients and determine whether any associations among cost and early (3-6 months) functional performance after hip fracture exist.

Principal Investigator: Robin Marcus
Department: PHYSICAL THERAPY - COH
Co Investigator: Robert Briggs
Co Investigator: Robin Marcus
Co Investigator: Micah Drummond
Co Investigator: Paul LaStayo

Contact Information

Name:Robert Briggs
Phone: 208-520-6884
Email: robert.briggs@hsc.utah.edu

Inclusion Criteria

We will recruit 50 older subjects with hip fracture and/or hip replacement. 

Inclusion/Exclusion criteria are outlined below:

1. Age > 50 yrs

2. Ability to sign informed consent

3. Mental status exam MoCA score > 22

4. Independent community ambulator prior to hip fracture/hip replacement

5. Ability to ambulate with or without an assistive device >50 feet.

 

Exclusion Criteria

1. Previous hip fracture or previous hip replacement

2. Bilateral hip fractures

3. Pathological fracture

4. Expected life expectancy less than one year

5. Permanently institutionalized

6. Fracture was a result of a multi-trauma (i.e. motor vehicle accident)

7. Cardiac abnormalities considered exclusionary by the study physician (e.g. CHF, CAD, unstable angina)

8. Neuromuscular impairments (i.e., Parkinson's Disease, spinal stenosis, spondylosis, etc.)

9. Unstable medical conditions (diabetes, kidney disease etc.)

10. Elevated systolic pressure >150 or a diastolic blood pressure > 100.

11. Implanted electronic devices (e.g., pacemakers, electronic infusion pumps, stimulators)

12. History of stroke with motor disability

13. Alcohol or drug abuse

14. Respiratory disease (acute upper respiratory infection, history of chronic lung disease with resting oxygen saturation <97% on room air)

15. Any other condition or event considered exclusionary by the PI and physician