Structured Tailored Rehabilitation After Hip Fragility Fracture

Summary

Why the investigators are doing this study? The best approach to rehabilitation after a broken hip is not known. A new approach could improve outcomes by tailoring rehabilitation to patient needs. This approach identifies subgroups of patients within a population who have different risks of poor outcomes. These subgroups are then matched to treatments better tailored to their needs. Survivors of a broken hip describe a tailored approach as key to recovery. Further, the NHS recommends this approach as central to healthcare progress.

This study wants to see if it is possible for the NHS to deliver this new approach to rehabilitation for older adults who break their hip.

What will be done? The investigators worked with patients to plan this study. Patients will keep helping the investigators during the study. Sixty older people who had surgery to fix a broken hip will be invited to take part. Participants will be given a level of risk (low, medium, or high) based on an online calculator (www.stratifyhip.co.uk).

All 60 participants will get usual care provided locally. Half, selected by chance, will get extra rehabilitation during their hospital stay including a self-managed exercise programme for the low-risk subgroup, education, a goal-orientated mobility programme and enhanced discharge planning for the medium-risk subgroup, and education, a goal-orientated activity of daily living programme, orientation, and enhanced assessment for the high-risk subgroup.

The investigators will collect information from the 60 people taking part, at the beginning, middle, and end of the study and again 12- weeks later.

What will the next step be? If this small study shows this extra rehabilitation can be provided in the NHS, and it may help patients, then the investigators plan to do a larger study. The larger study will see if this extra rehabilitation works to help older people get back home and feel happier.

Conditions

• Hip Fractures

Interventions

OTHER

Low-risk subgroup

Self-managed exercise programme.

OTHER

Medium-risk subgroup

Education, goal-orientated mobility programme, and enhanced discharge planning.

OTHER

High-risk subgroup

Education, enhanced assessment, orientation, and goal-orientated activities of daily living training programme.

OTHER

Control group

Usual care entails physiotherapy and occupational therapy from the day after surgery to the point of discharge, with a focus on discharge planning and sufficient recovery of activities of daily living and mobility for safe return to prefracture residence.

Sponsors & Collaborators

• UK Research and Innovation

  collaborator OTHER

• King's College London

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

60 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2024-04-15

Primary Completion

2025-01-30

Completion

2025-06-01

Countries

• United Kingdom

Study Locations