Long-term home-based physical exercise, pain, and use of pain medication over a year after hip fracture – A secondary analysis of a randomised controlled trial

Objective To study the effects of a year-long, supervised home-based exercise training on perceived pain, pain interference, and use of pain medication over 12 months after hip fracture. Design Randomised clinical trial, secondary analysis Setting Home Participants Participants ( n = 121) had surgical repair of a hip fracture, were ≥60 years old, and community-living. Intervention Participants were allocated into 12-month home-based Physical Exercise ( n = 61) or Usual Care ( n = 60). Exercise sessions (60 minutes/twice a week) at participants’ home under physiotherapist supervision including strength, balance, and functional exercises. Main measures Pain intensity, interference, and locations, and information of the pain medication were queried at baseline, 3, 6 and 12 months. Results The mean age was 81 (SD 7) years, 91 (75%) were women, and 74 (61%) had fractured femoral neck. At baseline, in Physical Exercise 46 (75%) and in Usual Care 43 (72%) reported some sort of pain. After discharge, 118 (98%) used pain medication: 116 (96%) paracetamol and 41 (34%) opioids. At 12 months, there was no difference between groups in global pain prevalence, or in pain intensity, but the prevalence of hip pain ( P = .047, effect size −0.38 (95% CI −0.51 to −0.22)) and pain interference ( P = .042, effect size −0.18 (95% CI −0.52 to −0.05)) were lower in Physical Exercise than in Usual Care. At 12 months, there was no difference in medication use between the groups. Conclusion The year-long supervised home-exercise reduced pain interference, and the prevalence of hip pain compared to usual care. Over 12 months the use of pain medication decreased in both groups. Registration ClinicalTrials.gov (NCT02305433)