BACKGROUND: It is not clear whether occupational therapy is of value for hip fracture patients. PATIENTS AND METHODS: In a randomized trial we studied the effects of an early, individualized, postoperative occupational training (OT) program on the ability of hip fracture patients to perform ADL and IADL. Secondary endpoints were self-reported fear of pain and pain when performing ADL and IADL. The need for technical aids and/or home adaptations was also investigated. 100 eligible patients (aged > or = 65 years, with independent residence) were randomized 50:50 to an OT or control group (conventional care). During their hospital stay, members of the OT group received individual daily training which included the use of technical aids. Before discharge, the occupational therapist paid a home visit together with the patient. All patients were assessed 2-4 days after surgery, at discharge and after 2 months, using the Klein-Bell ADL scale and a modified version of the Disability Rating Index. RESULTS: At discharge, the OT group had better ability to dress, to take care of personal hygiene and bathing activities independently, and to make toilet visits. Age, sex, type of fracture or length of stay at the hospital made no significant contribution to explaining the better ADL ability on discharge. After 2 months, all patients had regained their ADL and IADL abilities. Half of the patients required technical aids and adaptations in their homes. INTERPRETATION: Individualized OT-training speed up the ability of patients to perform ADL, thus enhancing the likelihood of patients returning to independent living and reducing the need for postoperative care at home.
RCT Entities:
BACKGROUND: It is not clear whether occupational therapy is of value for hip fracturepatients. PATIENTS AND METHODS: In a randomized trial we studied the effects of an early, individualized, postoperative occupational training (OT) program on the ability of hip fracturepatients to perform ADL and IADL. Secondary endpoints were self-reported fear of pain and pain when performing ADL and IADL. The need for technical aids and/or home adaptations was also investigated. 100 eligible patients (aged > or = 65 years, with independent residence) were randomized 50:50 to an OT or control group (conventional care). During their hospital stay, members of the OT group received individual daily training which included the use of technical aids. Before discharge, the occupational therapist paid a home visit together with the patient. All patients were assessed 2-4 days after surgery, at discharge and after 2 months, using the Klein-Bell ADL scale and a modified version of the Disability Rating Index. RESULTS: At discharge, the OT group had better ability to dress, to take care of personal hygiene and bathing activities independently, and to make toilet visits. Age, sex, type of fracture or length of stay at the hospital made no significant contribution to explaining the better ADL ability on discharge. After 2 months, all patients had regained their ADL and IADL abilities. Half of the patients required technical aids and adaptations in their homes. INTERPRETATION: Individualized OT-training speed up the ability of patients to perform ADL, thus enhancing the likelihood of patients returning to independent living and reducing the need for postoperative care at home.
Authors: Lauren A Beaupre; C Allyson Jones; L Duncan Saunders; D William C Johnston; Jeanette Buckingham; Sumit R Majumdar Journal: J Gen Intern Med Date: 2005-11 Impact factor: 5.128
Authors: David J Keene; Colin Forde; Thavapriya Sugavanam; Mark A Williams; Sarah E Lamb Journal: BMC Musculoskelet Disord Date: 2020-07-04 Impact factor: 2.362
Authors: Paul Baker; Carol Coole; Avril Drummond; Sayeed Khan; Catriona McDaid; Catherine Hewitt; Lucksy Kottam; Sarah Ronaldson; Elizabeth Coleman; David A McDonald; Fiona Nouri; Melanie Narayanasamy; Iain McNamara; Judith Fitch; Louise Thomson; Gerry Richardson; Amar Rangan Journal: Health Technol Assess Date: 2020-09 Impact factor: 4.014