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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.
JAMA.
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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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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