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Hospital outreach rehabilitation following hip fracture repair for nursing home residents improves mobility outcomes: A single blind randomized control trial
3rd International Conference and Expo on Physiotherapy
Maggie Killington, Owen Davies, Ruth Walker, Michelle Miller, Ian Cameron, Susan Kurrle, Mellick Chehade and Maria Crotty
Flinders University, Australia
Repatriation General Hospital, Australia
University of Sydney, Australia
University of Adelaide, Australia
Question: Does ��?Home Rehabilitation� following hip fracture repair improve mobility for nursing home residents?
Design: Previously walking nursing home residents (n=240) with hip fractures received 4 weeks of home rehabilitation in their
nursing home or usual care. In parallel, families and nursing home staff for the first 30 participants were invited to share their
perceptions of the journey for residents at interviews/focus groups.
Intervention: Physiotherapy (minimum 3 session��?s week for 4 weeks) focused on restoration of transfers and limited mobility.
Outcome Measures: The nursing home life space diameter (NHLSD), mobility status including level of independence and qualitative
data organized as a thematic analysis with the assistance of NVivo 10 were collected.
Results: Nursing home residents who received ��?Home Rehabilitation� mobilized further and more frequently as assessed by the
NHLSD (p<0.0001). More ��?Home Rehabilitation� participants were reported to have regained independent mobility with a lower
burden of care compared to usual care participants. Acute care staff struggled to provide people with dementia mobility retraining
and nursing home staffs were ill-equipped to provide post-operative care including mobility retraining and pain management on
their return home.
Conclusion: Following hip fracture surgery, ��?Home Rehabilitation� for nursing home residents was feasible and improved
independence with mobility was achieved.
Key Practice Points: 1) Strategies need to be developed to engage people who have dementia in early rehabilitation in the acute
setting; and 2) mobile nursing home residents with dementia who fractured their hips can improve their mobility levels in response
to outreach physiotherapy.