Prolonged strength training in older patients after hip fracture: a randomised controlled trial

Objective: the aim of this study was to assess the effect of a 12-week once-a-week prolonged strength-training programme in a group of home-dwelling older hip fracture patients. Design: randomised, controlled; single-blind parallel-group trial. Setting: intervention at outpatient's clinic. Subjects: 95 patients with surgical fixation for a hip fracture completed a preceding 3-month progressive strength-training programme twice a week. Methods: the programme comprised four exercises, performed at 80% of maximum capacity. Measurements were taken after 12 weeks of intervention. Outcome measurements were Berg Balance Scale (BBS), the sit-to-stand test, timed up-and-go test, maximal gait speed, 6-min walk test, Nottingham Extended Activities of Daily Living scale and the Short Form-12 questionnaire. Results: we found no statistically significant difference between groups in the primary outcome BBS, presumably because of a ceiling effect. The intervention group showed significant improvements in strength, gait speed and gait distance, instrumental activities of daily living and self-rated health. Conclusions: twelve weeks of progressive strength training performed once a week, as a follow-up to a more intensive training period, seemed to improve strength and endurance and resulted in better self-reported NEADL and self-rated health after hip fracture. Hip fracture patients seem to constitute a group that needs long-term follow-up to achieve the improvements necessary for independent functioning.