A new model of physiotherapy rehabilitation to improve outcomes after hip fracture

Ms Catherine Senserrick1, Professor  Nicholas Taylor1,2, Mr  Grant  Scroggie1, Ms Kim Williams1, Ms Kate Lawler1, Professor Genevieve Kennedy1, Ms Katherine Fox1

1Peter James Centre (eastern Health), Blackburn, Australia, 2La Trobe University, , Australia

Abstract: 

Aim: Patients in rehabilitation after hip fracture surgery are typically prescribed one session of 30-45 minutes of physiotherapy 5 days/week. The aim of this study was to investigate if three short sessions of physiotherapy each therapy day for this patient group was more effective than one long session in improving mobility.

Method: Participants receiving inpatient rehabilitation after hip fracture were randomly allocated to receive physiotherapy 3×15 minute sessions (intervention), or 1×45 minute session daily. The primary outcome was the De Morton Mobility Index (DEMMI) at admission, day 14 and discharge. Secondary measures included length of stay, daily steps, proportion of patients returning to their own home, and 30-day readmission rate.

Results: A total of 76 patients (38 patients each group) were recruited. There were no between-group differences for any primary or secondary outcomes. All participants achieved a clinically significant change in the DEMMI at 14 days, and at discharge. There was no between-group difference in amount of active therapy received.

Significance of findings to Allied Health: Both models of physiotherapy rehabilitation were effective at improving patients’ mobility. The new model providing three short sessions of physiotherapy rehabilitation each day was not superior to one longer session, suggesting the choice of model should be based on therapist and patient preference, taking account of pragmatic factors such as scheduling efficiency. Family members could also be trained to deliver some of the shorter sessions if appropriate.

Biography: 

Catherine has worked as a physiotherapist for 27 years across a number of settings. She has worked in the musculoskeletal field for the past 18 years, and moved into a rehabilitation setting 3 years ago into her current role as physiotherapy team leader at Peter James Centre