Approximately 30,000 adults in Quebec over the age of 50 suffer a fragility fracture each year. Fractures can affect a person's health, well-being and autonomy. Personal costs of these fractures are high, with as many as 50% of hip fracture patients being unable to return their pre-fracture level of autonomy. Homecare and community services provide customary rehabilitation support immediately following discharge from acute-care, though this contribution can be limited by lack of resources. For those patients at risk of negative outcomes, we have demonstrated clinically important benefits of extended exercise rehabilitation programs offered beyond the regular rehabilitation period on improving physical function. Through advances in sensor and telecommunication technology, eHealth solutions incorporated within homecare services as an integral part of the continuum of care can lead to better patient and health professional experience, improve clinical outcomes and reduce costs to the healthcare system. The purpose of this study is to determine if the implementation of a 3-month community-based extended-rehabilitation e-Monitoring and Coaching support program is more effective at improving mobility in community-dwelling elderly patients who have sustained a fracture than a printed material support program, and if these effects persist 6 months after discontinuation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
63
3-month community-based extended-rehabilitation e-Monitoring and Coaching support program
Printed material support
McGill University Health Centre
Montreal, Quebec, Canada
Jewish General Hospital
Montreal, Quebec, Canada
St. Mary's Hospital Center
Montreal, Quebec, Canada
Change in mobility
Measured as an ordinal mobility response variable quantified by the number of minimal clinically important changes (MIC) a participant attains using the gait speed and 30 second Sit to Stand tests. A person making no MIC in either measure is given a response category of 0, the lowest. A person changing by 1 MIC on only of the measures (either one) will be given a value of 1; a MIC gain on both measures would be assigned a value of 2, and so forth.
Time frame: 0, 1, 3, and 7 months
Change in grip strength
Measured using a Jamar™ hand dynamometer.
Time frame: 0, 1, 3, and 7 months
Change in walking endurance
Measured using the 2-minute walk test.
Time frame: 0, 1, 3, and 7 months
Change in balance
Measured using the Berg Balance Scale.
Time frame: 0, 1, 3, and 7 months
Change in the spatial area an individual moves through
Measured using the Life Space Mobility Assessment
Time frame: 0, 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 months
Change in global function status
Measured using the Reintegration to Normal Living Index (RNLI)
Time frame: 0, 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 months
Change in perceived physical health status
Measured by the physical function subscale of the RAND-36
Time frame: 0, 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 months
Change in Health-related quality of life
Measured by the EQ-5D
Time frame: 0, 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 months
Change in patient-reported health perception
Measured by the How Are You Today? Visual Analog Health States
Time frame: 0, 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 months
Change in goal directed behavior
Measured by the Apathy Evaluation Scale
Time frame: 0, 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 months
Change in global quality of life (QOL)
Measured by Patient Generated Index (PGI)
Time frame: 0, 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 months
Change in cognition
Measured by the Perceived Deficits Questionnaire (PDQ)
Time frame: 0, 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 months
Change in confidence in maintaining balance while doing daily activities.
Measured by the Activities-specific Balance Confidence Scale (ABC-S)
Time frame: 0, 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 months
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