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Older adults' sedentary behavior and physical activity after hip fracture: results from an outpatient rehabilitation randomized controlled trial |
Zusman EZ, Dawes M, Fleig L, McAllister MM, Cook WL, Guy P, Brasher PMA, McKay HA, Khan KM, Ashe MC |
Journal of Geriatric Physical Therapy 2019 Apr-Jun;42(2):E32-E38 |
clinical trial |
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
BACKGROUND AND PURPOSE: Prolonged sedentary time and limited physical activity can result in deleterious effects on health and mobility, especially for older adults with fall-related hip fracture. Therefore, the purpose of this study was to examine the effect of a multidisciplinary clinic on sedentary behavior and physical activity (prespecified secondary outcomes) and provide descriptions of activity patterns over 1 year for men and women. METHODS: We conducted a parallel-group, single-blinded randomized controlled trial comparing a multidisciplinary clinic and usual care (intervention) with usual care (control). We recruited 53 community-dwelling older adults aged 65+ years who were 3 to 12 months postfracture and collected data at baseline, 6, and 12 months; study staff were blinded to group allocation. The clinic included a geriatric assessment by the geriatrician, physiotherapist, and occupational therapist. Referrals were made to other professionals, when indicated. We collected the accelerometer-measured sedentary behavior and physical activity at 3 time points. We used linear mixed-effects models to compare groups at 6 and 12 months and mixed models to compare outcomes between men and women. RESULTS: Participants were sedentary for more than 10 hours of a 13-hour day, and there were no significant differences between the study groups at 6 months (2.4 (95% confidence interval -22.4 to 27.2) minutes) or 12 months (-3.7 (95% confidence interval -33.6 to 26.1) minutes). Compared with women, men spent 47.2 min/d more in sedentary time (p = 0.052) and 43.8 min/d less in light physical activity (p = 0.047). DISCUSSION: Older adults after hip fracture spend prolonged periods of waking hours sedentary with very little activity.
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