Effects of Tele-Rehabilitation Compared with Home-Based in-Person Rehabilitation for Older Adult’s Function after Hip Fracture

Abstract

This study aimed to examine the effect of a multidisciplinary tele-rehabilitation program on functional recovery of older adults with hip fracture compared with home-based in-person rehabilitation. In this single-blinded, non-randomized clinical trial, we included older with hip fracture. The tele-rehabilitation group received a 12-week tele-rehabilitation program (supervised by their family caregivers). The control group received the usual postoperative rehabilitation provided by the Andalusian health system (Spain). The primary outcome was the patient-reported functional status assessed with the Functional Independence Measure. We also measured performance-based functional recovery using the Timed Up and Go Test and Short Physical Performance Battery. We performed both a per-protocol (62 participants; 28 tele-rehabilitation and 34 control groups) and an intention-to-treat analysis (71 participants; 35 tele-rehabilitation and 36 control groups). Participants who used the tele-rehabilitation program had higher Functional Independence Measure scores (high effect size: 0.98 Cohen’s d; p < 0.001) and better performance in the Timed Up and Go Test (medium effect size: 0.63 Cohen’s d; p = 0.025) compared with the control group. Differences between groups post-intervention were not statistically significant in the Short Physical Performance Battery. The tele-rehabilitation intervention proposed in this study is a valuable treatment option in the recovery process for older adults with hip fracture. ClinicalTrials.gov Identifier: NCT02968589.

Does Telerehabilitation Help in Reducing Disability among People with Musculoskeletal Conditions? A Preliminary Study

“…The results showed that the intervention group achieved statistically significant improvements in pain intensity, mechanical pain sensitivity and psychological distress compared to a control group [ 34 ]. Telerehabilitation has also been used to support home-based exercises following hip surgery in the elderly, where exercises were delivered by caregivers at home instead of a health professional and guided by video recordings [ 35 ]. This controlled study showed that, regardless of the intervention received, both groups improved function, but the telerehabilitation program was superior at three months for improving function [ 35 ].…”

“…Telerehabilitation has also been used to support home-based exercises following hip surgery in the elderly, where exercises were delivered by caregivers at home instead of a health professional and guided by video recordings [ 35 ]. This controlled study showed that, regardless of the intervention received, both groups improved function, but the telerehabilitation program was superior at three months for improving function [ 35 ].…”

Iterative Development and Applicability of a Tablet-Based e-Coach for Older Adults in Rehabilitation Units to Improve Nutrition and Physical Activity: Usability Study

“…Although studies on eHealth interventions are already being conducted in the context of geriatric rehabilitation, apps have only been considered as a form of intervention in a few studies to date, and many applications relate to specific clinical conditions, particularly in the neurological field [ 14 ]. In older adults with limited mobility and after hip fractures, positive effects on mobility, functional outcomes, and hospitalization could be achieved through telerehabilitation interventions with an app [ 16 ] or via web sites [ 15 , 51 ]. However, these applications do not focus on educating participants but rather on teaching exercises.…”

“…However, the results on the applicability of eHealth with the target group indicated that interventions are feasible if adequate training takes place, and if the eHealth intervention is simple and has good usability [ 14 ]. For example, a study on telerehabilitation via a website compared with conventional rehabilitation after a hip fracture showed that patients in the telerehabilitation group achieved better functional scores than those in the control group [ 15 ]. In addition, in a study by Bean et al [ 16 ], the implementation of a 12-month web-based training program using a tablet and supervised by a physiotherapist led to a significant reduction in emergency department visits and hospital admissions in older adults with mobility impairments.…”

An m‐Health telerehabilitation and health education program on physical performance in patients with hip fracture and their family caregivers: Study protocol for the ActiveHip+ randomized controlled trial

“…Additionally, a sensitivity analysis will be performed to test the influence of potential confounders in the results, such as basic demographic data from both patients and caregivers, health status, duration of the hospital stay, falls in the last year, type of fracture, rehabilitation sessions received, or the setting where they receive the treatment. The z ‐scores and between‐subject Cohen's d will be calculated as effect size indicators according to previously published intervention studies (Ortiz‐Piña et al, 2021). All analyses will be performed using the SPSS software (version 25.0, IBM Corporation,), and the level of significance will be set at p < 0.05.…”