Physical Therapy Home Care After Hip Fracture

In this report, physical therapists (PTs) describe a tpical home care program for patients after a hip fracture. With shorter hospital stays and faster discharge times, many older adults need the services of a PT to regain function.

Activities of daily living can be very difficult to manage alone after this disabling injury. The patient often needs assistance walking and managing stairs. Studies show that patients who are able to return home after a hip fracture have better results than those who go to a skilled nursing facility or nursing home. And there are fewer deaths among patients who receive home care PT after a hip fracture.

The current status of home care PT includes active range of motion exercises and functional training activities. These training activities include moving in bed (rolling over, sitting up), getting in and out of bed, and tub or shower transfers. Balance and safety training are also included. Some therapists add stretching and resistance training. Balance training, breathing exercises, and aerobic conditioning were included by some, but not all, therapists.

This information was summarized from a survey taken of over 1,000 PTs providing home care. The authors describe the process by which the survey was developed, tested, and given. Details of data collection and analysis were also reported. A few regional differences were noted but for the most part, answers to survey questions were very similar.

The next step is to identify treatments that lead to the best results or outcomes for home physical therapy after hip fracture. Some studies already show that exercise with resistance is needed. With this added feature of the treatment program, mobility disabilities may be decreased. Specific exercises and the intensity, frequency, and duration of the chosen exercises remain to be determined.

Ongoing research is needed. For example, adding an aerobic exercise or high-intensity exercise may be needed.There may be There may be a specific combination of exercises that work best to restore function after hip fracture. Physical therapists are the most likely group to further extend this research and report new findings. The final result may be a home care PT program that provides faster and more complete recovery after hip fracture.

Reference: 

Kathleen Kline Mangione, et al. Intervention Used By Physical Therapists in Home Care for People After Hip Fracture. In Physical Therapy. February 2008. Vol. 88. No. 2. Pp. 199-210.

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