Extended Home Exercise Delivers Limited Benefit After Hip Fracture

Patients who follow a home exercise program after a hip fracture are more likely to remain active than those who receive usual care. However, such a program does not necessarily translate to other benefits.

Orwig and associates conducted a controlled trial of 180 community-based women who were randomized to home-based exercise (trainer-supervised aerobics plus strengthening) or usual care (short hospitalization and 2 to 4 weeks of physical therapy) after hip fracture. They theorized that the extended exercise would preserve bone mineral density (BMD), maintain lean muscle mass and strength, and improve activity levels and psychosocial functioning.

The home-based program was widely accepted (more than 80% of women allowed trainers into their homes) and was safe and well-tolerated. Also, home-treated women were more active than those receiving usual care. However, extended exercise did not produce statistically significant improvement in BMD or other measured outcomes, such as fat mass and ability to perform activities of daily living.

The authors noted that their low-intensity, home-based exercise program is a feasible delivery strategy and can be used as a model for developing more home-based services to enhance adherence and promote independence after completion of services.