Individual research recommendation details

Recommendation ID

CG124/04

Question

Intensive rehabilitation therapies after hip fracture: What is the clinical and cost effectiveness of additional intensive physiotherapy and/or occupational therapy (for example, progressive resistance training) after hip fracture?

Any explanatory notes
(if applicable)

Why this is important?
The rapid restoration of physical and self-care functions is critical to recovery from hip fracture, particularly where the goal is to return the person to preoperative levels of function and residence. Approaches that are worthy of future development and investigation include progressive resistance training, progressive balance and gait training, supported treadmill gait re‑training, dual task training and activities of daily living training. The optimal time point at which these interventions should be started requires clarification.

The ideal study design is a randomised controlled trial. Initial studies may have to focus on proof of concept and be mindful of costs. A phase 3 randomised controlled trial is required to determine clinical effectiveness and cost effectiveness. The ideal sample size will be around 400 to 500 patients, and the primary outcome should be physical function and health-related quality of life. Outcomes should also include falls. A formal sample size calculation will need to be undertaken. Outcomes should be followed over a minimum of 1 year, and compare if possible, either the recovery curve for restoration of function or time to attainment of functional goals.

Source guidance details

Comes from guidance

Hip fracture: management

Number

CG124

Date issued

June 2011

Other details