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The application of "upper-body yoga" in elderly patients with acute hip fracture: a prospective, randomized, and single-blind study
Guo J, Gao C, Xin H, Li J, Bing L, Zhuan W, Yue Y
Journal of Orthopaedic Surgery and Research 2019 Aug 6;14(250):Epub
clinical trial
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

PURPOSES: Hip fracture leads to decreased activity and an increased risk of pulmonary complications. The main purpose of this study was to observe the lung capacity, cough capacity of the elderly patient with acute hip fracture, and assess the effects and the feasibility of using a special-designed "upper-body yoga" training to treat elderly patients with hip fracture. METHODS: This was a prospective, randomized, and single-blind study. Eighty-four subjects aged over 65 years were randomly divided into either a control group or a yoga group to undergo an abdominal breathing program or an "upper-body yoga" program until 4 weeks after surgery. The primary outcomes were forced vital capacity/predicted value (FVC%), peak cough flow (PCF), Barthel Index (BI), and the incidence of pneumonia. The secondary outcomes were the rates of right skills and inclination. RESULTS: Thirty-nine subjects in the yoga group and 40 subjects in the control group completed this study. At the end of the first training week, FVC% (74.14% +/- 13.11% versus 70.87% +/- 10.46%, p = 0.231) showed no significant difference between the two groups, while the value of PCF (204.80 +/- 33.45 L/min versus 189.06 +/- 34.80 L/min, p = 0.048) and BI (38.59 +/- 8.66 versus 33.00 +/- 9.32, p = 0.009) in the yoga group was higher. After 4 weeks of treatment, FVC%, PCF, and BI were higher in the yoga group (78.83% +/- 13.31% versus 72.20% +/- 10.53%, p = 0.016; 216.16 +/- 39.29 L/min versus 194.95 +/- 31.14 L/min, p = 0.008; 70.77 +/- 10.23 versus 65.75 +/- 11.30, p = 0.019). One in the control group and nobody in the yoga group was diagnosed with pneumonia. There was no significant difference between the two groups in terms of the rates of right skills, whereas more elderly people preferred the training program of the "upper-body yoga." CONCLUSION: Elderly patients with acute hip fractures are at risk of impaired lung capacity and inadequate cough. "Upper-body yoga" training may improve the quality of daily life, vital capacity, and cough flow in elderly patients, making it a better choice for bedridden patients with hip fracture.

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