Enhanced Rehabilitation Targeting Strength and Movement Pattern Symmetry Following Hip Fracture
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Utah
- Enrollment
- 24
- Primary Endpoint
- muscle power
Study Overview
Brief Summary
This study evaluates the feasibility of implementing a unilaterally biased high-intensity resistance training to facilitate restorative vs. compensatory recovery after "usual care" physical therapy among older adults who have recently incurred a hip fracture. Additionally, physical performance during a sit-to-stand task, muscle function (strength/power), physical function measures, muscle composition, and muscle quality (force/unit area), are assessed before and after targeted high-intensity resistance training.
Detailed Description
Hip fracture is a major public health concern in the United States. Fall-related injuries constitute the leading cause of deaths and disabilities among persons over age 65 years. Hip fracture is consistently identified as one of the most frequent, costly, and devastating non-lethal injuries from a fall. Rehabilitation after hip fracture remains largely unchanged over the last 30 years despite evidence that high-intensity rehabilitation can benefit physical function after hip fracture beyond the recovery typical with "usual care".
Asymmetries demonstrated in physical performance of various tasks, such as gait, balance, and a sit-to-stand transfer, and impaired surgical limb muscle function are evident for years after hip fracture, and may contribute to the high rate of falls and declining function typically encountered by older adults recovering from hip fracture. Implementing a high-intensity rehabilitation approach targeting asymmetries after hip fracture is likely to yield improved symmetry in both physical function and muscle function. This study will recruit older adults who have recently incurred a hip fracture and completed "usual care" physical therapy to determine whether a high-intensity rehabilitation strategy targeting asymmetries in movement strategies and muscle function of the surgical limb can be successfully implemented in this challenging population. In particular, recruitment, adherence to rehab protocol parameters, and retention will be addressed among those who initiate high-resistance training at approximately 8-12wk after hip fracture incidence.
In addition, the investigators will explore the potential of targeted unilaterally-biased resistance training to improve surgical limb function and performance after hip fracture. Specifically, physical performance, muscle function, and muscle quality/composition are recorded and compared pre-/post-training to determine whether improvements occur in conjunction with high-intensity rehabilitation training. Additionally, the investigators will measure improvements in muscle composition that occur as a result of this high-intensity resistance training.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 50 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age greater than 50 yrs
- •Ability to sign informed consent
- •Mental Status MoCA score greater than 22
- •Independent community ambulatory prior to hip fracture
- •Ability to ambulate greater than 50 feet with or without assistive device
Exclusion Criteria
- •Previous hip fracture
- •Bilateral hip fracture
- •Pathological fracture
- •Expected life Expectancy less than one year
- •Permanently institutionalized
- •Fracture result of multi-trauma
- •Cardiac abnormalities
- •Neuromuscular impairments
- •Unstable medical conditions
- •Elevated systolic greater than 150 or diastolic blood pressure greater than 100
- •Implanted electronic devices
- •History of stroke with motor disability
- •Alcohol or drug abuse
- •Respiratory disease
- •Conditions deemed exclusionary by PI or physician
Arms & Interventions
Experimental
High-Intensity, Unilaterally-Biased Resistance training 3x/wk x 12wk "MOVE"
Intervention: Unilaterally Biased Resistance Training / "MOVE" (Behavioral)
Outcomes
Primary Outcomes
muscle power
Time Frame: 12 week
Leg extension muscle power was measured on a Nottingham power rig in watts (W). The average of three trials was used.
muscle strength
Time Frame: 12 week
Knee extension muscle strength was measured on an isokinetic dynamometer as a maximum voluntary isometric contraction in newtons (N) of force. The average of three trials was used.
Secondary Outcomes
- sit-to-stand task performance(12 week)
- usual gait speed(12 week)
- Activities Specific Balance Scale(12 week)
- Six minute walk test(12 week.)
- Modified Physical Performance Test(12 week)
- muscle mass(12 week)
- Stair Descent Test(12 week)
- Berg Balance Scale(12 week)
- Stair Climb Test(12 week)
- Timed up and Go Test(12 week)
- Lower Extremity Measure(12 week)
Investigators
Robin Marcus
Ph.D.
University of Utah