Tele-rehabilitation following hip fracture

The effects of home-based occupational tele-rehabilitation for patients following a surgically repaired hip fracture

Background

The prevalence of hip fractures is increasing due to an aging population worldwide. While almost all geriatric hip fractures are now treated in the hospital, less than half of patients reach their functional pre-fracture status. This can negatively impact mobility and daily life (ADL), and in turn, increase the risk of falls.

Given this, there is a high rate of hospital re-admission following a hip fracture, with falls accounting for the majority of incidents. In fact, patients with limited mobility are re-admitted twice as often as patients who were able to walk independently before their hip fracture occurred.


Objective

The objective was to investigate the feasibility and effects of home-based occupational tele-rehabilitation using the software from Caspar Health on functional and motor performance - and as well as fall risk - in outpatient rehabilitation patients following a surgically repaired hip fracture.


Methods

Conducted at the Hong Kong Polytechnic University Hospital, this was a randomized controlled feasibility study of geriatric patients who attended a day hospital and underwent surgery within 12 weeks after a hip fracture diagnosis.

Study participants underwent assessments of their motor-skill performance, ability to complete day-to-day activities (ADL), and fall risk, both at the beginning and end of their post-operative treatment – and three weeks after their treatment’s conclusion. The intervention group used the Caspar app for the home therapy program, while the comparison group received their training instructions on paper.


Results

From a total of 31 recruited patients over 60 years of age, a comparison of the groups showed statistically significant improvements in the intervention group, both after treatment and during follow-up, in the area of fall risk and day-to-day activities.


Conclusion and outlook

The study reinforces the importance of post-operative tele-therapy treatment via smartphone as an alternative to conventional post-operative treatment in geriatric hip fracture patients.


Literature: Li CT, Hung GK, Fong KN, Gonzalez PC, Wah SH, Tsang HW. Effects of a home-based occupational therapy telerehabilitation via smartphone for outpatients after hip fracture surgery: a feasibility randomised controlled study. J Telemed Telecare. 2022 May;28(4):239-247. doi: 10.1177/1357633X20932434.

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