Efficacy of a Post-Rehabilitation Exercise Intervention

描述（由申请人提供）：本项目的总体目标是确定康复结束后许多髋部骨折患者仍然存在的重大功能问题是否可以通过简单，易于传播的程序减少或消除。这项研究的具体目的是证明，如果功能改善可以实现正式髋部骨折康复结束后，通过使用一个实用的，以家庭为基础的锻炼计划，称为生活（SFL）。SFL干预将认知训练和行为强化与运动训练相结合，以实现高水平的坚持。与NIA和NCMMR任务的相关性：该项目通过调查一种创新的多学科方法来解决这些机构的任务，以提高残疾老年人的独立性，福祉和生活质量。在先前针对功能受限老年人的随机临床试验中，SFL参与者已经实现了高水平的依从性，并在与治疗师接触最少的情况下改善了力量，流动性和减少残疾。这项拟议的研究将扩展以前的工作，通过证明该计划的安全性和有效性的成年人谁接受正式的康复服务后髋部骨折和谁显示在他们的正常康复过程结束时，他们的身体功能的限制。参与者将随机接受6个月的SFL计划或注意力控制干预（营养咨询）。SFL参与者将接受锻炼和认知训练，并从物理治疗师那里获得后续行为强化。设盲结局评估员将在6个月和9个月随访时使用体能测试和自我报告措施评估该计划对身体功能和残疾的影响。所有的分析都将通过意向治疗进行。与公共卫生的相关性：在髋部骨折康复结束后，许多人仍然在行走和日常活动方面存在问题。这项研究将发现，康复结束后，人们可以在自己家里进行的锻炼计划，其中包括增加人们的动力和信心的特殊技术，是否有助于他们更加独立。这种低成本的计划可以被许多髋部骨折后的人使用，并可能有助于减少需要搬到养老院或需要长期家庭帮助的人数。

DESCRIPTION (provided by applicant): The overall objective of this project is to determine if the significant functional problems that remain for many hip fracture patients after rehabilitation ends can be reduced or eliminated by a simple, easily disseminated program. The specific aim of this study is to demonstrate if functional improvement can be achieved after formal hip fracture rehabilitation ends through the use of a practical, home-based exercise program, called Strong for Life (SFL). The SFL intervention incorporates cognitive training and behavioral reinforcements with exercise training to achieve high levels of adherence. Relevance to the missions of NIA and NCMMR: This project addresses the missions of these agencies by investigating an innovative, multidisciplinary approach to enhance the independence, well-being and quality of life of older adults with a disability. In previous randomized clinical trials with older adults with functional limitations, the SFL participants have achieved a high level of adherence, and improved strength, mobility and reduced disability with minima contact from a therapist. This proposed study will extend previous work by demonstrating this program's safety and effectiveness in a sample of adults who have received formal rehabilitation services following hip fracture and who display limitations in their physical function at the end of their normal course of rehabilitation. Participants will be randomized either to receive the SFL program for 6 months, or an attention control intervention (nutrition counseling). SFL participants will receive exercise and cognitive training and follow-up behavioral reinforcements from a physical therapist. Blinded outcome assessors will evaluate the program's impact on physical function and disability using physical performance tests and self- report measures at 6- and 9-month follow-up. All analyses will be by intention to treat. Relevance to public health: After rehabilitation for a hip fracture ends, many people continue to have problems walking and doing their daily activities. This study will find out whether an exercise program that people can do in their own home after their rehabilitation ends which includes special techniques to increase people's motivation and confidence helps them to be more independent. This low-cost program could be used by many people after hip fracture, and could potentially help to reduce the number of people who need to move to a nursing home or need long term home help.