Timing And Intensity Of Strengthening After Hip Fracture

描述（由申请人提供）：尽管髋部骨折的医疗管理有了巨大的进步，但我们在减少老年人骨折后遗留的显著残障方面仍未成功。这种看似简单的疾病的经济成本和护理人员和社会承担的护理负担预计会升级。有必要对有希望的干预措施进行系统调查。干预措施应具体针对阻碍恢复的缺陷，即肌肉质量和力量，应具有正确的强度，并在最适当的时间引入，以实现最有益的结果。这笔计划拨款将用于完善未来的一项试验，一项以家庭为基础的锻炼计划。研究人员建议评估锻炼计划的强度和时间，以降低髋部骨折后的残疾水平。该计划将用于设计一项随机对照试验（RCT），以比较在骨折后不同时间进行的两种不同强度的下肢运动与假注意力对照组。在未来的试验中，研究人员计划纳入更大范围的髋部骨折患者，而不是只关注那些最有可能康复的患者。他们还将记录当前康复护理的各个方面，并确定预测这种干预成功的因素。

DESCRIPTION (provided by applicant): Despite dramatic improvements in medical management of hip fracture, we have been unsuccessful in reducing the significant residual disability that remains in older persons post-fracture. The burgeoning economic cost of this seemingly simple condition and the burden of care borne by caregivers and society are predicted to escalate. Systematic investigations of promising interventions are needed. The interventions should be specific to the deficits that impede recovery, i.e., muscle mass and strength, should be of the correct intensity and be introduced at the most appropriate time to achieve the most beneficial outcome. This planning grant will be used to refine a future trial, a home-based exercise program. The investigators propose to evaluate the intensity and timing of an exercise program to reduce the level of disability post-hip fracture. This planning effort will be used to design a randomized controlled trial (RCT) to compare two different intensities of lower extremity exercise delivered at different times post-fracture to a sham, attention control group. In this future trial the investigators plan to include a broader range of patients with hip fracture than has been included in previous studies instead of focusing only on individuals with the best chance for recovery. They also will document aspects of current rehabilitation care, and identify the factors that predict success of this intervention. The planning project brings together a dynamic group of investigators expert in studying hip fracture outcomes and clinical methodologies. The investigative team consists of experts in hip fracture outcomes, clinical methodologies, and physical intervention required to design and lead a randomized controlled trial of an exercise program following hip fracture. Specific aims of the present application for a planning and development grant are to (1) refine the study design of the future trial; (2) prepare detailed protocols for successful enrollment of subjects in the future trial; (3) establish reliable procedures to ensure treatment adherence; (4) prepare detailed protocols to enable meaningful outcome assessment in the future trial; and (5) develop the future trial budget.