TESTING THE EXERCISE PLUS PROGRAM FOLLOWING HIP FRACTURE

描述：（改编自研究者摘要）髋部骨折是一种主要的 公共卫生问题。超过50%的患者不能恢复到骨折前 骨折后一年的功能水平。髋部骨折后的恢复 通过康复服务和锻炼可以大大改善。在 老年人，经常锻炼可以预防疾病，降低跌倒的风险， 减少残疾，改善睡眠，改善情绪和整体健康。 特别是对于髋部骨折后的老年人，运动可以改善活动能力 （速度和负重能力）、力量、功能表现，以及 防止将来的福尔斯。不幸的是，大多数老年人不这样做。 经常锻炼，大约50%的开始锻炼计划的人 六个月后退学本研究的主要目的是测试 有效性的家庭交付自我效能为基础的干预， 锻炼加计划，增加老年人髋关节后的锻炼行为 骨折参与者将被随机分配到四个组中的一个 由2 × 2设计定义：（1）运动训练器组件，包括 由运动教练定期家访以实施运动计划 （2）仅含激励性成分的附加成分 干预措施，但没有一个运动教练行使;（3）充分 Exercise Plus计划，包括Plus组件（激励 干预）和运动训练器组件;或（4）常规护理。五 将使用参与巴尔的摩髋关节研究的急症护理机构 招募参与者。共有240名（每组60名）老年人将在 包括在研究中。基线测试将在急性护理环境中进行， 以及在家庭环境中实施的干预， 康复服务已经完成。与以下方面相关的疗效预期 运动，运动行为，活动，功能表现，健康状况， 疼痛、情绪、对跌倒的恐惧、福尔斯以及与福尔斯相关的伤害将被 在基线时测量，然后在髋关节置换术后2个月、6个月和12个月时测量 骨折主要结局将是疗效预期、运动 行为和活动;次要结果将侧重于以下方面的益处： 锻炼（如改善功能）。广义估计方程将是 用于使用二元和连续结局指标进行分析 作为因变量。研究人员表示，这项研究将有助于 了解哪些干预措施可以改善老年人的运动行为， 老年人髋部骨折后，并添加到目前的知识基础 关于身体虚弱的老年人锻炼的好处。

DESCRIPTION: (Adapted from Investigator's Abstract) Hip fracture is a major public health problem. More than 50% of patients do not return to pre-fracture functional levels one year post fracture. Recovery following hip fracture has been shown to be greatly improved by rehabilitation services and exercise. In older adults, regular exercise prevents disease, decreases the risk of falling, reduces disability, improves sleep, and enhances mood and general well-being. Specifically for older adults post hip fracture, exercise can improve mobility (speed and weight-bearing ability), strength, functional performance, and prevent future falls. Unfortunately, the majority of older adults do not exercise regularly, and approximately 50% of those who begin exercise programs drop out by six months. The major aim of this study is to test the effectiveness of a home delivered self-efficacy based intervention, the Exercise Plus Program, on increasing exercise behavior in older adults post hip fracture. Participants will be randomly assigned to one of the four groups defined by the 2 X 2 design: (1) Exercise Trainer component which includes regular home visits by an exercise trainer to implement an exercise program with patients; (2) Plus Component only which includes motivational interventions but without an exercise trainer to exercise with; (3) the full Exercise Plus program which includes the Plus Component (motivational interventions) and the Exercise Trainer component; or (4) routine care. Five acute care facilities participating in the Baltimore Hip Studies will be used to recruit participants. A total of 240 (60 per group) older adults will be included in the study. Baseline testing will be done in the acute care setting, and the intervention implemented in the home setting when traditional inpatient rehabilitation services are completed. Efficacy expectations related to exercise, exercise behavior, activity, functional performance, health status, pain, mood, fear of falling, falls, and injuries related to falls will be measured at baseline, and then at two, six, and twelve months post hip fracture. The primary outcomes will be efficacy expectations, exercise behavior, and activity; secondary outcomes will focus on the benefits of exercise (such as improved function). Generalized estimating equations will be used to perform the analyses with both binary and continuous outcome measures as dependent variables. The investigators state that this study will contribute to the understanding of what interventions improve exercise behavior in the older adult post hip fracture, and add to the current base of knowledge regarding the benefits of exercise in frail older persons.