Effects of the @ctivehip tele-rehabilitation program on the quality of life, psychological factors and fitness level of patients with hip fracture: Controlled trial (Preprint)

BACKGROUND Hip fracture has a severe impact on patients’ quality of life, psychological factors and fitness level. Tele-rehabilitation has emerged in the last years as a promising alternative to conduct the rehabilitation process at home. However, there is no studies testing the effects of tele-rehabilitation interventions for patients with hip fracture on quality of life nor psychological factors, whereas the evidence on fitness level is scarce. OBJECTIVE To test the effects of the @ctivehip tele-rehabilitation program on the quality of life, psychological factors and fitness level of patients who had suffered a hip fracture. METHODS It is a non-randomized clinical trial including patients with 65 five years old onwards with a hip fracture as well as their family caregivers. The intervention group received a home-based multidisciplinary tele-rehabilitation intervention called @ctivehip lasting 12 weeks and the control group received the traditional care and rehabilitation provided by the Andalusian Public Health Care System. The outcomes measured were the patients’ quality of life through the EuroQol Quality of Life Questionnaire (EQ-5D), physiological factors (anxiety and depression) using the Hospital Anxiety and Depression Scale (HADS), and the fitness level, assessed with the International Fitness Scale (IFIS). Per-protocol (64 participants) and intention-to-treat (71 participants) analyses were performed, being the first one the main analysis. RESULTS The quality of life of the tele-rehabilitation group increased, while the control group scored worst at 3-month follow-up (medium effect size: 0.66 SDs; p = 0.006). The tele-rehabilitation group demonstrated a greater decrease than the control group in the total HADS score (medium effect size: -0.50 SDs; p = 0.015). Lastly, the tele-rehabilitation group recovered a fitness level close to the pre-hip fracture in comparison with the control group (small effect size: 0.49 SDs; p = 0.022). CONCLUSIONS The @ctivehip tele-rehabilitation program seem to be a promising treatment to improve the quality of life and psychological factors (i.e., anxiety and depression) of older adults after a hip fracture, as well as to recover their previous fitness level. CLINICALTRIAL ClinicalTrials.gov (Identifier: NCT02968589).