Effects of High-Intensity Progressive Resistance Training and Targeted Multidisciplinary Treatment of Frailty on Mortality and Nursing Home Admissions after Hip Fracture: A Randomized Controlled Trial
Abstract
Rationale Excess mortality and residual disability are common after hip fracture. Hypothesis Twelve months of high-intensity weight-lifting exercise and targeted multidisciplinary interventions will result in lower mortality, nursing home admissions, and disability compared with usual care after hip fracture. Design Randomized, controlled, parallel-group superiority study. Setting Outpatient clinic Participants Patients (n = 124) admitted to public hospital for surgical repair of hip fracture between 2003 and 2007. Intervention Twelve months of geriatrician-supervised high-intensity weight-lifting exercise and targeted treatment of balance, osteoporosis, nutrition, vitamin D/calcium, depression, cognition, vision, home safety, polypharmacy, hip protectors, self-efficacy, and social support. Outcomes Functional independence: mortality, nursing home admissions, basic and instrumental activities of daily living (ADLs/IADLs), and assistive device utilization. Results Risk of death was reduced by 81% (age-adjusted OR [95% CI] = 0.19 [0.04-0.91]; P Conclusion The HIPFIT intervention reduced mortality, nursing home admissions, and ADL dependency compared with usual care.
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A range of positive effects are reported after six to twelve months for nutritional interventions in orthogeriatric patients, e.g. reduced length of hospital stay, improved independence in activities of daily living, improved mobility, reduced in-hospital falls and fall-related injuries, decreased emergency department visits, significantly fewer days of delirium, fewer pressure ulcers, reduced-nut
“A range of positive effects are reported after six to twelve months, e.g.reduced length of hospital stay (55,56), improved independence in activities of daily living (56,192,193), improved mobility (56), reduced in-hospital falls and fall-related injuries (57), decreased emergency department visits (192) significantly fewer days of delirium (55), fewer pressure ulcers (55), reduced nursing home ad”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [193]
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- Authors
- Singh, N. A., Quine, S., Clemson, L. M., Williams, E. J., Williamson, D. A., Stavrinos, T. M., Grady, J. N., Perry, T. J., Lloyd, B. D., Smith, E. U. R., & Singh, M. A. F.
- Affiliations
- The University of Sydney (AU)
- Venue
- Journal of the American Medical Directors Association
- Publisher
- Elsevier BV
- Published
- 2012-01
- Volume
- 13
- Issue
- 1
- Pages
- 24-30
- ISSN
- 1525-8610 (ISSN-L)
- OpenAlex
- W2020412968
- Cited by
- 274
- References
- 4
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 12 · 2023: 18 · 2022: 19 · 2021: 17 · 2020: 24 · 2019: 17 · 2018: 13 · 2017: 30 · 2016: 19 · 2015: 20 · 2014: 28 · 2013: 30 · 2012: 16
- FWCI
- 24.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Medical Directors Association (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Hip and Femur Fractures
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Keywords
- hip fracture, high-intensity resistance training, frailty, mortality, nursing home admission, activities of daily living, instrumental activities of daily living, functional independence, assistive devices, multidisciplinary rehabilitation, osteoporosis, balance, depression, self-efficacy, polypharmacy, hip protectors, older adults
- MeSH terms
- Aged, Aged, 80 and over, Ambulatory Care, Female, Hip Fractures, Humans, Male, Mortality, New South Wales, Nursing Homes, Outcome Assessment, Health Care, Interdisciplinary Communication, Resistance Training, Sarcopenia
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