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Soukkio PK, Suikkanen SA, Sintonen H, Kukkonen-Harjula KT, Kautiainen H, Kääriä SM, Hupli MT, Aartolahti EM, Pitkälä KH, Sipilä S. Health-related quality of life after hip fracture: effects of a 12-month home-based exercise intervention-secondary analyses of an RCT. Qual Life Res 2024; 33:541-550. [PMID: 37932555 DOI: 10.1007/s11136-023-03545-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE In this randomized controlled trial, we analyzed the effects of a 12-month home-based exercise intervention on the health-related quality of life (HRQoL) of patients with a hip fracture. METHODS Participants (n = 121) aged ≥ 60 years, with a Mini-Mental State Examination (MMSE) score of ≥ 12 and an operated hip fracture, were placed into Exercise (n = 61) or Usual care (n = 60) groups. Physiotherapist-supervised, home-based training was given twice a week over 12 months. HRQoL was assessed using the 15D instrument at baseline and at 3, 6, and 12 months. The total 15D scores and dimension scores were analyzed and compared to national age- and sex-matched reference data. RESULTS The participants' mean age was 81 years (SD 7), 75% were women, and 61% had a femoral neck fracture. The mean within-group change in total 15D score over 12 months was 0.023 (95% CI: -0.003 to 0.048) in the Usual care group, and 0.028 (CI: 0.003 to 0.054) in the Exercise group (between-group p = 0.76). We found a statistically significant change in total 15D score in the Exercise group, as well as in the dimension scores of mobility and usual activities in both groups. All 15D scores remained below the general population reference level. CONCLUSION Exercise training for 12 months did not enhance the HRQoL of home-dwelling patients with hip fractures any more than usual care. In addition, HRQoL remained below the population level in both groups.
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Affiliation(s)
- Paula K Soukkio
- Rehabilitation, South Karelia Social and Health Care District (Eksote), Valto Käkelän Katu 14D, 53130, Lappeenranta, Finland.
- Development Services, Wellbeing Services County of South Karelia, Valto Käkelän Katu 14D, 53130, Lappeenranta, Finland.
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Rautpohjankatu 8, 40700, Jyväskylä, Finland.
| | - Sara A Suikkanen
- Rehabilitation, South Karelia Social and Health Care District (Eksote), Valto Käkelän Katu 14D, 53130, Lappeenranta, Finland
- Faculty of Health Care and Social Services, LAB University of Applied Sciences, Yliopistonkatu 36, 53850, Lappeenranta, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, PO Box 20, 00014, Helsinki, Finland
| | - Katriina T Kukkonen-Harjula
- Rehabilitation, South Karelia Social and Health Care District (Eksote), Valto Käkelän Katu 14D, 53130, Lappeenranta, Finland
| | - Hannu Kautiainen
- Primary Health Care Unit, Kuopio University Hospital, PO BOX 100, 70029 KYS, Kuopio, Finland
- Folkhälsan Research Center, Haartmaninkatu 8, 00290, Helsinki, Finland
| | - Sanna M Kääriä
- Raatimiehet Oy, Raatimiehenkatu 18, 53100, Lappeenranta, Finland
| | - Markku T Hupli
- Rehabilitation, South Karelia Social and Health Care District (Eksote), Valto Käkelän Katu 14D, 53130, Lappeenranta, Finland
| | - Eeva M Aartolahti
- Institute of Rehabilitation, JAMK University of Applied Sciences, Piippukatu 2, 40100, Jyväskylä, Finland
| | - Kaisu H Pitkälä
- Department of General Practice, University of Helsinki, Tukholmankatu 8 B, 00290, Helsinki, Finland
- Unit of Primary Health Care, Helsinki University Hospital, Tukholmankatu 8 B, 00290, Helsinki, Finland
| | - Sarianna Sipilä
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Rautpohjankatu 8, 40700, Jyväskylä, Finland
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Wang L, Wang X, Zhang R, He C. Emerging trends and prospects in telerehabilitation for hip fracture: Bibliometric and visualization study. Digit Health 2024; 10:20552076241255465. [PMID: 38798887 PMCID: PMC11128182 DOI: 10.1177/20552076241255465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
Background Telerehabilitation provide distant physical rehabilitation services and help overcome the barriers associated with face-to-face interventions for hip fractures. This study aims to analyse the progress of the application of telerehabilitation in hip fracture and reveal its research profile, hotspots and development trends. Methods The articles and reviews related to telerehabilitation in hip fracture were retrieved from 1992 to 2024. A bibliometric visualization and comparative analysis of countries, institutions, journals, authors, references and keywords were conducted using Java-based CiteSpace and VOSviewer. Results A total of 79 documents were obtained. Spain was the most academically influential country. The University of Granada was the most prolific institution. The author Ariza-vega P listed first in terms of publications and citations. Most publications were published in high academic impact journals. The major frontier keywords were "older adults," "functional recovery," "reliability," "mortality," "rehabilitation," "mobility" and "quality of life." The most popular keywords from 2020 to 2024 were "geriatric medicine," "family caregiver" and "digital health." Conclusions The historical and prospective perspective in telerehabilitation following hip fracture were presented. A primary focus in the early years was the impact of telerehabilitation on functional independence for hip fracture patients. Future outcomes are expected to include patient satisfaction, health-related quality of life and psychiatric symptoms. Exercise was also designed to eliminate travel burdens and strengthen self-efficacy, and improve the physical and psychosocial function of hip fracture patients. This work will provide a fundamental reference as well as a directional guide for future research.
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Affiliation(s)
- Liqiong Wang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Xiangxiu Wang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Ruishi Zhang
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Chengqi He
- Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, P. R. China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, P. R. China
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Mutchie HL, Orwig DL, Gruber-Baldini AL, Johnson A, Magaziner J, Falvey JR. Associations of sex, Alzheimer's disease and related dementias, and days alive and at home among older Medicare beneficiaries recovering from hip fracture. J Am Geriatr Soc 2023; 71:3134-3142. [PMID: 37401789 PMCID: PMC11087867 DOI: 10.1111/jgs.18492] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/18/2023] [Accepted: 06/07/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Males constitute 25% of older adults who experience hip fractures in the United States; a concerning upward trend given poorer health and outcomes among male survivors. Male sex is associated with worse cognitive performance after hip fracture, impacting participation in rehabilitation and long-term outcomes especially for those with Alzheimer's disease or related dementias (ADRD). However, little research has evaluated whether sex differences in post-fracture recovery are greater among those living with ADRD. METHODS Data were drawn from 2010 to 2017 Medicare fee-for-service beneficiaries aged 65 years and older who survived hospitalization for hip fracture (n = 69,581). The primary outcome was days alive and at home (DAAH), a validated patient-centered claims-based outcome calculated as 365 days from fracture minus days in hospital, nursing home, rehabilitation facility, emergency department, or time after death. Multivariable Poisson regressions with an interaction term between sex and ADRD status were to model the association between DAAH and ADRD in the 12 months post hip fracture, adjusting for demographics, injury severity, chronic disease burden, and hospital-level fixed effects. RESULTS Compared to females, males were younger and had more comorbidities at the time of fracture. Among survivors, males with ADRD spent a mean of 160.7 DAAH compared to 228.4 for males without ADRD, 177.8 for females with ADRD, and 248.0 for females without ADRD. In adjusted analyses, males without ADRD spent 8.2% fewer DAAH compared to females (rate ratio [RR] = 0.92, 95% CI 0.92-0.92). This relative sex difference increased significantly when comparing those living with ADRD, with males spending an additional 3.3% fewer DAAH (interaction RR = 0.96, 95% CI 0.96-0.97). CONCLUSIONS Males spend fewer DAAH after hip fracture than females, and this difference increases modestly for males living with ADRD compared to females. This suggests that cognitive impairment may be a small but significant contributor to sex-based differences observed during hip fracture recovery.
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Affiliation(s)
- Heather L. Mutchie
- University of Maryland School of Medicine, Department of Epidemiology & Public Health, Division of Gerontology
- Purdue University, School of Health Science, School of Nursing
| | - Denise L. Orwig
- University of Maryland School of Medicine, Department of Epidemiology & Public Health, Division of Gerontology
| | - Ann L. Gruber-Baldini
- University of Maryland School of Medicine, Department of Epidemiology & Public Health, Division of Gerontology
| | - Abree Johnson
- University of Maryland School of Pharmacy, Department of Pharmaceutical Health Services Research
| | - Jay Magaziner
- University of Maryland School of Medicine, Department of Epidemiology & Public Health, Division of Gerontology
| | - Jason R. Falvey
- University of Maryland School of Medicine, Department of Epidemiology & Public Health, Division of Gerontology
- University of Maryland School of Medicine, Department of Physical Therapy and Rehabilitation Science
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Soukkio PK, Suikkanen SA, Kukkonen‐Harjula KT, Kautiainen H, Hupli MT, Aartolahti EM, Kääriä SM, Pitkälä KH, Sipilä S. Effects of a 12-month home-based exercise program on functioning after hip fracture - Secondary analyses of an RCT. J Am Geriatr Soc 2022; 70:2561-2570. [PMID: 35582993 PMCID: PMC9790677 DOI: 10.1111/jgs.17824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 03/12/2022] [Accepted: 04/03/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Long-term functional limitations are common after hip fractures. Exercise may alleviate these negative consequences but there is no consensus on an optimal training program. The objective was to study the effects of a 12-month home-based supervised, progressive exercise program on functioning, physical performance, and physical activity. METHODS Secondary analysis of a randomized controlled trial targeting patients with surgical repair of a hip fracture, aged ≥60 years, Mini-Mental State Examination (MMSE) score of ≥12. The participants were randomized into Exercise (n = 61) or Usual care (n = 60). Assessments at baseline, 3, 6, and 12 months included Lawton's Instrumental Activities of Daily Living (IADL), Short Physical Performance Battery (SPPB), handgrip strength, and self-reported frequency of sessions of leisure-time physical activity. Analyzed using mixed-effects models. RESULTS Participants' (n = 121) mean age was 81 years (SD 7), and 75% were women. The mean IADL score at baseline was 17.1 (SD 4.5) in the exercise group, and 17.4 (5.1) in the usual care group. The mean SPPB scores were 3.9 (1.6) and 4.2 (1.8), and handgrip strength was 17.7 (8.9) kg and 20.8 (8.0) kg, respectively. The age- and sex-adjusted mean changes in IADL over 12 months were 3.7 (95% CI 2.8-4.7) in the exercise and 2.0 (1.0-3.0) in the usual care group (between-group difference, p = 0.016); changes in SPPB 4.3 (3.6-4.9) and 2.1 (1.5-2.7) (p < 0.001); and changes in handgrip strength 1.2 kg (0.3-2.0) and 1.0 kg (-1.9 to -0.2) (p < 0.001), respectively. We found no between-group differences in changes in the frequency of leisure-time activity sessions. CONCLUSION A 12-month home-based supervised, progressive exercise program improved functioning and physical performance more than usual care among patients with hip fractures. However, the training did not increase leisure-time physical activity.
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Affiliation(s)
- Paula K. Soukkio
- Department of Rehabilitation, South Karelia Social and Health Care District (Eksote)LappeenrantaFinland,Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland,Gerontology Research Center and Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
| | - Sara A. Suikkanen
- Department of Rehabilitation, South Karelia Social and Health Care District (Eksote)LappeenrantaFinland,Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
| | | | - Hannu Kautiainen
- Department of General PracticeUniversity of HelsinkiHelsinkiFinland
| | - Markku T. Hupli
- Department of Rehabilitation, South Karelia Social and Health Care District (Eksote)LappeenrantaFinland
| | - Eeva M. Aartolahti
- Institute of RehabilitationJAMK University of Applied SciencesJyväskyläFinland
| | | | - Kaisu H. Pitkälä
- Department of General PracticeUniversity of HelsinkiHelsinkiFinland,Unit of Primary Health CareHelsinki University HospitalHelsinkiFinland
| | - Sarianna Sipilä
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland,Gerontology Research Center and Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
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Douzi W, Bon D, Suikkanen S, Soukkio P, Boildieu N, Nenonen A, Hupli M, Kukkonen-Harjula K, Dugué B. 1H NMR Urinary Metabolomic Analysis in Older Adults after Hip Fracture Surgery May Provide Valuable Information for Patient Profiling-A Preliminary Investigation. Metabolites 2022; 12:metabo12080744. [PMID: 36005617 PMCID: PMC9415398 DOI: 10.3390/metabo12080744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/30/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022] Open
Abstract
In these times of precision and personalized medicine, profiling patients to identify their needs is crucial to providing the best and most cost-effective treatment. In this study, we used urine metabolomics to explore the characterization of older adults with hip fractures and to explore the forecasting of patient outcomes. Overnight urine specimens were collected from 33 patients (mean age 80 ± 8 years) after hip fracture surgery during their stay at a rehabilitation hospital. The specimens were analyzed with 1H NMR spectroscopy. We performed a metabolomics study regarding assessments of frailty status, Functional Independence Measure (FIM), and Short Physical Performance Battery (SPPB). The main metabolic variations concerned 10 identified metabolites: paracetamol derivatives (4 peaks: 2.15 ppm; 2.16 ppm; 7.13 ppm and 7.15 ppm); hippuric acid; acetate; acetone; dimethylamine; glycine; alanine; lactate; valine; TMAO. At baseline, the urinary levels of these metabolites were significantly higher (i) in frail compared with non-frail patients, (ii) in persons with poorer FIM scores, and (iii) in persons with poorer compared SPPB scores. Our findings suggested that patients with increased levels of urine metabolites associated with metabolic, inflammatory, and renal disorders presented clear signs of frailty, impaired functional independence, and poor physical performance. Metabolomics could be a valuable tool to further characterize older adults, especially after major medical events.
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Affiliation(s)
- Wafa Douzi
- Laboratoire «Mobilité, Vieillissement, Exercice (MOVE)—UR 20296», Faculté des Sciences du Sport, Université de Poitiers, 8 Allée Jean Monnet, 86000 Poitiers, France
| | - Delphine Bon
- INSERM U1313, (IRMETIST), Poitiers, France and Faculty of Medicine and Pharmacy, University of Poitiers, 86000 Poitiers, France
| | - Sara Suikkanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland
- Faculty of Social Services and Health Care, LAB University of Applied Sciences, 53130 Lappeenranta, Finland
| | - Paula Soukkio
- Rehabilitation and Laboratory Center, South Karelia Social and Health Care District (Eksote), Valto Käkelän katu 3, 53130 Lappeenranta, Finland
| | - Nadège Boildieu
- INSERM U1313, (IRMETIST), Poitiers, France and Faculty of Medicine and Pharmacy, University of Poitiers, 86000 Poitiers, France
| | - Arja Nenonen
- Rehabilitation and Laboratory Center, South Karelia Social and Health Care District (Eksote), Valto Käkelän katu 3, 53130 Lappeenranta, Finland
| | - Markku Hupli
- Rehabilitation and Laboratory Center, South Karelia Social and Health Care District (Eksote), Valto Käkelän katu 3, 53130 Lappeenranta, Finland
| | - Katriina Kukkonen-Harjula
- Rehabilitation and Laboratory Center, South Karelia Social and Health Care District (Eksote), Valto Käkelän katu 3, 53130 Lappeenranta, Finland
| | - Benoit Dugué
- Laboratoire «Mobilité, Vieillissement, Exercice (MOVE)—UR 20296», Faculté des Sciences du Sport, Université de Poitiers, 8 Allée Jean Monnet, 86000 Poitiers, France
- Correspondence: ; Tel.: +33-549-454-040; Fax: +33-549-453-396
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