Exercise Prescription for a Patient 3 Months After Hip Fracture

• Published in: Physical therapy 2005-07, Vol.85 (7), p.676-687
• Main Authors: Mangione, Kathleen K, Palombaro, Kerstin M
• Format: Article
• Language: English
• Subjects: Adults; Aged; Care and treatment; Exercise; Exercise Therapy - methods; Female; Forecasts and trends; Fractures; Gait; Health aspects; Hip fractures; Hip Fractures - therapy; Hip joint; Humans; Intervention; Market trend/market analysis; Motivation; Older people; Physical fitness; Physical therapists; Physical therapy; Postural Balance; Treatment Outcome; Walking
• ISSN: 0031-9023; 1538-6724
• DOI: 10.1093/ptj/85.7.676

Most patients with hip fracture do not return to prefracture functional status 1 year after surgery. The literature describing interventions, however, does not use classic overload and specificity principles. The purpose of this case report is to describe the use of resistance training to improve functional outcomes in a patient following hip fracture. The patient was a 68-year-old woman who had a comminuted intertrochanteric fracture of the left hip 3 months previously. She used a cane for ambulation, and her walking was limited. The patient received 16 sessions of lower-extremity strengthening exercises, aerobic training on a stationary bicycle, functional training supervised by a physical therapist, and a home stretching program. The patient's isometric muscle force for involved hip extension, hip abduction, and knee extension improved by 86%, 138%, and 33%, respectively; walking endurance increased by 22.5%; balance improved by 400%; balance confidence increased by 41%; and self-reported ability to perform lower-extremity functional activities increased by 20%. The authors believe that some patients can perform comprehensive exercise programs after hip fracture and that properly designed programs can affect patient outcomes beyond observed impairments.