Grant: New Investigator Salary Award - PA: Patient-Oriented Research

BACKGROUND: Hip fracture is the second leading cause of hospitalization in seniors and is associated with loss of function and increased risk of death. Up to 25% of hip fractures occur within long-term care facilities, those providing long-term residential care for dependent individuals. For these residents, current postoperative care involves quickly discharging them from hospital to continue recovery in the long-term care setting. Although these residents are older and may have impaired mental status, at least 70% were walking prior to their hip fracture. INTERVENTION: Current evidence suggests that patients with impaired mental status can still respond positively to functional exercises. REGAIN I examined how long-term care patients recover after a hip fracture. REGAIN II, the current study, will explore how an exercise intervention {an Outreach Program} that consists of a rehabilitation team who travel to long-term care facilities to deliver exercise treatments to hip fracture patients after hospital discharge affects recovery of function. Subjects in the intervention arm will receive the Outreach Program {45 minutes/session; 3 times/week} for 10 weeks following their hip fracture while the control group will receive usual postoperative care. We will also examine if the Outreach Program is a feasible approach to offering treatment after a hip fracture for those who live in a long-term care setting. All subjects will be assessed at baseline {pre-fracture status}, and 3, 6, and 12 months after fracture. REGAIN II started enrollment in February 2011. EXPECTED OUTCOME: Our simple exercise program may assist recovery after hip fracture and, if effective, may even be applied to other conditions associated with hospitalization and the need for recovery of function {e.g. stroke, pneumonia, heart failure} that are common in nursing home residents.