TESTING THE EXERCISE PLUS PROGRAM FOLLOWING HIP FRACTURE

描述：(改编自《调查者摘要》)髋部骨折是主要的 公共卫生问题。超过50%的患者没有回到骨折前的状态 骨折后一年的功能水平。髋部骨折后的康复 通过康复服务和锻炼，情况得到了极大的改善。在……里面 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，增强情绪和整体幸福感。 特别是对于髋部骨折后的老年人来说，锻炼可以改善活动能力 (速度和负重能力)、强度、功能性能和 防止未来跌倒。不幸的是，大多数老年人并不这样认为 经常锻炼，大约50%的开始锻炼计划的人 退学六个月。这项研究的主要目的是测试 基于家庭递送自我效能感的干预效果 运动加计划，增加老年人髋关节术后的运动行为 骨折。参与者将被随机分配到四组中的一组 由2×2设计定义：(1)运动训练器组件，包括 由运动教练进行定期家访以实施运动计划 患者；(2)仅包含激励因素的Plus组件 干预措施，但没有锻炼教练；(3)完整的 Exercise Plus计划，包括Plus组件(激励 干预措施)和运动教练部分；或(4)常规护理。五 参加巴尔的摩髋关节研究的急性护理设施将被使用 招募参与者。总共240名(每组60名)老年人将被 包括在这项研究中。基线测试将在急性护理环境中进行， 以及传统住院患者在家庭环境下实施的干预措施 康复服务已完成。与以下内容相关的疗效期望 锻炼，锻炼行为，活动，功能表现，健康状况， 疼痛，情绪，对跌倒的恐惧，跌倒，以及与跌倒有关的伤害 在基线时测量，然后在髋关节后2、6和12个月测量 骨折。主要结果将是疗效预期、运动 行为和活动；次要结果将侧重于 运动(如改善机能)。广义估计方程将是 用于执行具有二元和连续结果衡量标准的分析 作为因变量。调查人员表示，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，并增加了目前的知识基础 关于运动对虚弱的老年人的好处。

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.