Improved Physical Function following a Three-Month, Home-Based Resistance Training Program for Fragile Patients with Poor Recovery Years after Femoral Neck Fracture—A Prospective Cohort Study

Abstract

Patients sustaining a hip fracture experience reduced function and an increased risk of recurrent falls and institutionalization following surgical treatment. Rehabilitation programs that are feasible for home-based training could improve patient-reported outcomes and physical function while lowering the care need and social dependency of this patient group. In the present study, we designed and tested a home-based resistance training program on a group of patients with a femoral neck fracture (FNF) selected according to their poor post-operative functional recovery following an FNF. The results showed that the training program was feasible to perform for the patients, and after three months of training, the patients’ walking, physical activity, and patient-reported outcome measures improved. The patients were encouraged to continue walking and performing the training program, but twelve months after the FNF, the results were comparable to the baseline. Background: Femoral neck fracture (FNF) is associated with reduced function, often leading to an increased care need and a greater risk of recurrent falls. Thus, rehabilitation should be a priority. The present study investigated the training potential among fragile FNF patients with poor functional performance treated with total hip arthroplasty. Methods: In a prospective cohort study, 32 participants were included based on poor functional recovery following an FNF fracture. The participants completed a three-month, physiotherapy-guided, home-based resistance training program. At the baseline and three-month follow-up, physiotherapists performed functional tests and measured spatiotemporal parameters, muscle strength, and muscle mass. The Oxford hip score (OHS) questionnaire was administered and physical activity measurements were performed at baseline and at three-month and 12-month follow-ups. Results: Walking distance, step length, walking speed, and muscle strength increased at the three-month follow-up (p p = 0.02) and walks of 5–10 min (p = 0.002) compared to the baseline. At the 12-month follow-up, physical activity was similar to the baseline. Conclusions: Fragile patients with low functional performance following FNF displayed training potential with an improvement in function, strength, and physical activity. However, continued training is necessary in order to maintain the positive effects.

Keywords

• hip fracture
• femoral neck fracture
• total hip arthroplasty
• rehabilitation
• muscle mass
• muscle strength