A multi-center trial of exercise and testosterone therapy in women after hip fracture: Design, methods and impact of the COVID-19 pandemic

Binder, Ellen F.; Christensen, Jesse C.; Stevens‐Lapsley, Jennifer E.; Bartley, Jenna M.; Berry, Sarah D.; Dobs, Adrian S.; Fortinsky, Richard H.; Hildreth, Kerry L.; Kiel, Douglas P.; Kuchel, George A.; Marcus, Robin L.; McDonough, Christine M.; Orwig, Denise; Sinacore, David R.; Schwartz, Robert S.; Volpi, Elena; Magaziner, Jay; Schechtman, Kenneth B.

doi:10.1016/j.cct.2021.106356

Cited by 6 publications

(5 citation statements)

References 43 publications

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“…Higher functional independence measure scores and better Timed Up and Go Test results were found in the intervention group Tele-rehabilitation in patients with hip fractures showing higher functional independence than in standard of care group Delbaere et al, 2021 [ 33 ] BMJ I RCT Australia Tests if a specific exercise program intended for older people and digitally delivered through an app (StandingTall) can reduce the rate of falls. No difference was seen in the first 12 months, but a slightly reduced fall rate over 24 months when compared with the control group App based exercise program showing no reduced rate of falls in elderly people after 12 months Binder et al, 2021 [ 42 ] Contemp Clin Trials II clinical trial USA Study protocol with the intention to evaluate the six minute walk distance and other parameters after testosterone gel application and a digital home exercise program after hip fracture in the elderly Study protocol McCarty et al, 2021 [ 46 ] JAMA Netw Open I RCT USA Examines if a collaborative care treatment is associated with improvements in patients with post concussive symptoms. The interventions provided were largely based on telehealth applications and succeeded in better improving symptoms in patients over one year Telehealth applications in patients with post concussive symptoms successfully improved symptoms over one year Wohlmann et al, 2021 [ 48 ] Telemed J E Health II RCT Germany Describes positive effects of a medical emergency data set on the comprehensiveness of a physician’s documentation and handover process to the emergency department of a hospital Positive impact of a digital medical emergency data set Ariza-Vega et al, 2021 [ 41 ] Phys Ther II clinical trial Spain Evaluates the family caregivers’ perspectives of the recovery process of th...…”

Section: Resultsmentioning

confidence: 99%

Telemedicine in orthopaedics and trauma surgery during the first year of COVID pandemic: a systematic review

Hofmann

Hildebrand

Mederake

et al. 2023

BMC Musculoskelet Disord

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Purpose Prior to the COVID-19 pandemic, telemedicine in orthopaedics and trauma surgery had mostly developed for joint arthroplasty, fracture management, and general pre- and postoperative care including teleradiology. With the corona-outbreak, telemedicine was applied on a broad scale to prevent assemblage and to guarantee access to medical care protecting critical areas. The purpose of the present study was to give an overview of the spectrum of clinical applications and the efficacy of telemedicine in orthopaedic and trauma surgery as published in times of the COVID-19 pandemic. Methods All published studies investigating the application of telemedicine related to orthopaedics and trauma during the COVID-19 pandemic were accessed and screened for suitability. The primary outcome of interest was the efficacy of telemedicine in various clinical applications. The secondary outcome of interest was the spectrum of different applications in which telemedicine applications were investigated. Results The literature search resulted in 1047 articles. After the removal of duplicates, 894 articles were screened of which 31 finally met the inclusion criteria. Dimensions that were described by studies in the literature to have positive effects were preoperative patient optimisation, the usefulness of telemedicine to correctly diagnose a condition, conservative treatment, willingness to and feasibility for telemedicine in patients and doctors, and postoperative/post-trauma care improvement. The efficacy of telemedicine applications or interventions thereby strongly varied and seemed to depend on the exact study design and the research question addressed. Conclusion Various successful applications of telemedicine have already been reported in orthopaedics and trauma surgery, with a strong increase in scientific output during the COVID-19 years 2020–2021. Whether the advantages of such an approach will lead to a relevant implementation of telemedicine in everyday clinical practice should be monitored after the COVID-19 pandemic.

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Section: Resultsmentioning

confidence: 99%

Telemedicine in orthopaedics and trauma surgery during the first year of COVID pandemic: a systematic review

Hofmann

Hildebrand

Mederake

et al. 2023

BMC Musculoskelet Disord

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“…Early functional exercises for fractures are mostly within 2 weeks after surgery, mainly to exercise muscle contraction and relaxation, and mid-term functional exercises are mostly within 3 to 6 weeks after surgery [ 23 ]. The exercise intensity can be gradually strengthened and large joint activities can be attempted, but activities that are not conducive to fracture connection and stability still need to be restricted [ 24 , 25 ]. Later functional exercises are mostly carried out after 6 weeks after surgery, and the limb function is gradually restored through comprehensive joint and muscle exercises [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Compliance of functional exercises in school-age children with limb fractures: implication for nursing countermeasures

Liu

Wang

et al. 2022

BMC Pediatr

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Background Functional exercises is very essential to the recovery of patients with fracture. We aimed to evaluate the compliance of functional exercises in school-age children with limb fracture, to provide evidence to the clinical management and nursing care of children with limb fracture. Methods School-age children with limb fractures treated in our hospital from January 1, 2020 to June 30, 2021 were selected. The characteristics and postoperative functional exercise compliance of included children were analyzed. Pearson correlation and Logistic regression analysis were conducted to analyze the influencing factors of compliance to functional exercises. Results A total of 328 children with limb fracture were included, the incidence of compliance to functional exercise was only 35.98%. Pearson correlation analysis showed that age(r = 0.707), only child of family(r = 0.537), guardians(r = 0.642) and type of temperament(r = 0.635) were correlated with compliance to functional exercises in school-age children with limb fractures (all p < 0.05). Logistic regression analysis indicated that age ≤ 10y (OR2.913, 95%CI2.091 ~ 3.611), only child of family (OR2.006, 95%CI1.683 ~ 2.558), guarded by grandparents (OR1.512, 95%CI1.201 ~ 2.118), non-easy-going temperament (OR4.127, 95%CI3.811 ~ 4.902) were the influencing factors of non-compliance to functional exercises in children with limb fracture (all p < 0.05). Conclusions School-age children have poor compliance with functional exercises after limb fractures, and there are many influencing factors. For children with those risks, health care providers should actively intervene in nursing to improve children’s exercise compliance and the rehabilitation effect.

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“…One ongoing multicenter trial is enrolling women with recent hip fracture and applying topical testosterone gel versus placebo to investigate the effect of testosterone on post-hip fracture surgery rehabilitation. 32 There are currently no data on the role TRT may play on early recovery in these settings. Evidence suggests higher endogenous levels of testosterone and exogenous supraphysiologic TRT can improve recovery rates after TKA.…”

Section: Effect Of Testosterone Replacement Therapy On Orthopaedic-re...mentioning

confidence: 99%

Testosterone Replacement Therapy in Orthopaedic Surgery

Cohn,

Ganz,

Scuderi

2024

J Am Acad Orthop Surg

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Testosterone replacement therapy (TRT) is an indicated treatment of several medical conditions including late-onset hypogonadism, congenital syndromes, and gender affirmation hormonal therapy. Increasing population age, medical benefits, and public awareness of TRT have resulted in increased prevalence of its utilization. However, TRT is not without concern for adverse risks including venous thromboembolic complications, cardiovascular events, and prostate issues. In the field of orthopaedic surgery, research is beginning to delineate the complex relationship between TRT and the development of orthopaedic conditions and potential effects on surgical interventions and outcomes. In this review, we discuss current literature surrounding TRT and subsequent development of osteoarthritis, incidence of total joint arthroplasty, musculotendinous pathology, postoperative infection risk, improvements in postoperative rehabilitation metrics, enhancement of osseous healing, and increased bone-implant integration. The authors suggest future areas of investigation that may provide guidance on how surgeons can mitigate adverse risks while optimizing benefits of TRT in the orthopaedic patient.

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A multi-center trial of exercise and testosterone therapy in women after hip fracture: Design, methods and impact of the COVID-19 pandemic

Cited by 6 publications

References 43 publications

Telemedicine in orthopaedics and trauma surgery during the first year of COVID pandemic: a systematic review

Telemedicine in orthopaedics and trauma surgery during the first year of COVID pandemic: a systematic review

Compliance of functional exercises in school-age children with limb fractures: implication for nursing countermeasures

Testosterone Replacement Therapy in Orthopaedic Surgery

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