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OBJECTIVE: To compare ambulation outcomes between home and institutional rehabilitation of patients with hip fracture. DESIGN: Randomized controlled clinical equivalence trial. SETTING: The Queen Elizabeth Hospital in Hong Kong. SUBJECTS: Eighty-one patients with hip fracture. INTERVENTION: Study group patients (40) were discharged directly home from the acute hospital and visited by a physiotherapist an average of 4.6 times. The control group subjects (41) were discharged to a rehabilitation centre for further treatment lasting on average 36.2 days (SD 14.6) and they received physiotherapy daily. MAIN OUTCOME MEASURES: Ambulation ability measured on a categorical scale. RESULTS: The mean age of the subjects was 75 years (SD 8.3 years). Females comprised 60% of all the subjects and majority were retired or home makers. Both groups of patients improved in their ambulation ability during their rehabilitation period but neither group achieved their pre-ambulatory status by the time of completion of the study. The study group achieved significantly higher ambulation scores (p < 0.05) for community and household ambulation compared with the control group by the end of the study, a year after operation. CONCLUSION: Five visits by a physiotherapist in the patient's home after discharge from an acute hospital after surgical treatment for hip fracture yielded better results in ambulation ability than one month of conventional institution-based rehabilitation.
Raija Kuisma (Thu,) studied this question.