Evidence-Based Orthopaedics   |    
Extended Physical Therapy with Progressive Resistance Training Improved Function in Frail Elderly Patients with Hip Fracture

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Sources of funding: National Institute on Aging; Washington University General Clinical Research Center; Washington University Clinical Nutrition Research Center; Barnes-Jewish Hospital Foundation.
For correspondence: Dr. E.F. Binder, Division of Geriatrics and Nutritional Sciences, Washington University School of Medicine, 4488 Forest Park Boulevard, Suite 201, St. Louis, MO 63108, USA. E-mail: ebinder@im.wustl.edu
Binder EF, Brown M, Sinacore DR, Steger-May K, Yarasheski KE, Schechtman KB. Effects of Extended Outpatient Rehabilitation After Hip Fracture: A Randomized Controlled Trial.
2004 Aug 18;292: 837-46.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2005 Feb 01;87(2):466-466
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Question: In community-dwelling frail elderly patients with hip fracture, does an extended physical therapy program that includes progressive resistance training improve physical function and reduce disability more than low-intensity home exercise?Design: Randomized (allocation concealed)*, blinded (outcome assessors), controlled trial with 6-month follow-up.*Information provided by author.Setting: St. Louis, Missouri.Patients: 90 community-dwelling patients =65 years of age (mean age, 81 y; 74% women) who were discharged from standard physical therapy prescribed for a recent fracture of the proximal part of the femur. Other inclusion criteria were an evaluation within 16 weeks of hip fracture, a modified Physical Performance Test (PPT) score of between 12 and 28, and a difficulty or need for assistance with =1 activity of daily living (ADL). Exclusion criteria included pathological fracture, bilateral femoral fracture, or previous contralateral femoral fracture; dementia, cognitive impairment, or a Short Blessed Test score of =11; an inability to walk 50 feet (15.24 meters) with use of an assistive device; visual or hearing impairments; cardiopulmonary or neuromuscular disease that would preclude participation in a weighttraining program; conditions that would not improve with exercise training; a recent course of medication for osteoporosis or recent hormone therapy; or a life expectancy of <1 year. Although follow-up was 94%, 24% of patients did not complete the extended program.
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