Maaike N Scheffers-Barnhoorn1, Monica van Eijk2, Jolanda C M van Haastregt3, Jos M G A Schols4, Romke van Balen2, Nan van Geloven5, Gertrudis I J M Kempen3, Wilco P Achterberg2. 1. Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: m.n.scheffers-barnhoorn@lumc.nl. 2. Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands. 3. Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. 4. Department of Health Services Research and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Department of Family Medicine and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. 5. Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, the Netherlands.
Abstract
OBJECTIVES:Fear of falling (FoF) is common after hip fracture and can impede functional recovery because of activity restriction. The Fear of falling InTervention in HIP fracture geriatric rehabilitation (FIT-HIP intervention) was designed to target FoF and consequently to improve mobility. The aim of this study was to evaluate the effect of the FIT-HIP intervention in patients with FoF in geriatric rehabilitation (GR) after hip fracture. DESIGN, SETTING, AND PARTICIPANTS: This cluster-randomized controlled trial was performed in 11 post-acute GR units in the Netherlands (2016-2017). Six clusters were assigned to the intervention group, 5 to the usual care group. We included 78 patients with hip fracture and FoF (aged ≥65 years; 39 per group). INTERVENTION(S): The FIT-HIP intervention is a multicomponent cognitive behavioral intervention conducted by physiotherapists, embedded in usual care in GR. The FIT-HIP intervention was compared to usual care in GR. MEASUREMENTS: FoF was assessed with the Falls Efficacy Scale-International (FES-I) and mobility, with the Performance Oriented Mobility Assessment (POMA). Data were collected at baseline, discharge, and 3 and 6 months postdischarge from GR. Primary endpoints were change scores at discharge. Linear mixed models were used to evaluate the treatment effect. RESULTS: No significant between-group differences were observed for primary outcome measures. With the usual care group as reference, the FES-I estimated difference between mean change scores was 3.3 [95% confidence interval (CI) -1.0, 7.5, P = .13] at discharge from GR; -4.1 (95% CI -11.8, 3.6, P = .29) after 3 months; and -2.8 (95% CI -10.0, 4.4, P = .44) after 6 months. POMA estimated difference was -0.3 (95% CI -6.5, 5.8, P = .90). CONCLUSION/IMPLICATIONS: The FIT-HIP intervention was not effective in reducing FoF. Possibly FoF (shortly) after hip fracture can to some extent be appropriate. This may imply the study was not able to accurately identify and accordingly treat FoF that is maladaptive (reflective of disproportionate anxiety).
RCT Entities:
OBJECTIVES: Fear of falling (FoF) is common after hip fracture and can impede functional recovery because of activity restriction. The Fear of falling InTervention in HIP fracture geriatric rehabilitation (FIT-HIP intervention) was designed to target FoF and consequently to improve mobility. The aim of this study was to evaluate the effect of the FIT-HIP intervention in patients with FoF in geriatric rehabilitation (GR) after hip fracture. DESIGN, SETTING, AND PARTICIPANTS: This cluster-randomized controlled trial was performed in 11 post-acute GR units in the Netherlands (2016-2017). Six clusters were assigned to the intervention group, 5 to the usual care group. We included 78 patients with hip fracture and FoF (aged ≥65 years; 39 per group). INTERVENTION(S): The FIT-HIP intervention is a multicomponent cognitive behavioral intervention conducted by physiotherapists, embedded in usual care in GR. The FIT-HIP intervention was compared to usual care in GR. MEASUREMENTS: FoF was assessed with the Falls Efficacy Scale-International (FES-I) and mobility, with the Performance Oriented Mobility Assessment (POMA). Data were collected at baseline, discharge, and 3 and 6 months postdischarge from GR. Primary endpoints were change scores at discharge. Linear mixed models were used to evaluate the treatment effect. RESULTS: No significant between-group differences were observed for primary outcome measures. With the usual care group as reference, the FES-I estimated difference between mean change scores was 3.3 [95% confidence interval (CI) -1.0, 7.5, P = .13] at discharge from GR; -4.1 (95% CI -11.8, 3.6, P = .29) after 3 months; and -2.8 (95% CI -10.0, 4.4, P = .44) after 6 months. POMA estimated difference was -0.3 (95% CI -6.5, 5.8, P = .90). CONCLUSION/IMPLICATIONS: The FIT-HIP intervention was not effective in reducing FoF. Possibly FoF (shortly) after hip fracture can to some extent be appropriate. This may imply the study was not able to accurately identify and accordingly treat FoF that is maladaptive (reflective of disproportionate anxiety).
Authors: D Pinto; M Alshahrani; R Chapurlat; T Chevalley; E Dennison; B M Camargos; A Papaioannou; S Silverman; J-F Kaux; N E Lane; J Morales Torres; J Paccou; R Rizzoli; O Bruyere Journal: Osteoporos Int Date: 2022-01-20 Impact factor: 4.507
Authors: Maaike N Scheffers-Barnhoorn; Monica van Eijk; Jos M G A Schols; Romke van Balen; Gertrudis I J M Kempen; Wilco P Achterberg; Jolanda C M van Haastregt Journal: BMC Geriatr Date: 2021-04-01 Impact factor: 3.921