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Effects of a simple home exercise program and vitamin D supplementation on health-related quality of life after a hip fracture: a randomized controlled trial

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Abstract

Purpose

To test the effects of vitamin D intervention and a simple home exercise program (HE) on health-related quality of life (HRQL) in the first 12 months after hip fracture.

Methods

HRQL was reported in 173 acute hip fracture patients (mean age 84 years, 79% females, 77% community dwelling) who were enrolled in the 12-month 2 × 2 factorial Zurich Hip Fracture Trial. Pre-fracture HRQL was assessed at baseline (4.2 ± 2.2 days post-surgery) and then again at 6 and 12 months after hip fracture surgery by the EuroQol EQ-5D-3L index value (EQ-5D-3L questionnaire). The effects of vitamin D intervention (2000 vs. 800 IU vitamin D3) and exercise (HE vs. no HE) or of the combined interventions on HRQL were assessed using multivariable-adjusted repeated-measures linear mixed-effects regression models.

Results

The EQ-5D-3L index value significantly worsened from 0.71 pre-fracture to 0.57 over 12 months, but the degree of worsening did not differ between individual or combined interventions. However, regarding only the late recovery between 6 and 12 months, the group receiving neither intervention (800 IU/day and no HE) experienced a significant further decline in the EQ-5D-3L index value (adjusted mean change = 0.08 [95% CI 0.009, 0.15], p = 0.03) while all other groups remained stable.

Conclusion

Hip fractures have a long-lasting negative effect on HRQL up to 12 months after hip fracture. However, HE and/or 2000 IU vitamin D per day may help prevent a further decline in HRQL after the first 6 months following the acute hip fracture event.

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Funding

This analysis was funded by the Baugarten Centre Grant for the Centre on Aging and Mobility (Dr. Bischoff-Ferrari), and by the University Research Priority Program “Dynamics of Healthy Aging” (Dr. Bischoff-Ferrari), University of Zurich. The original trial was supported by Swiss National Foundations (NFP-53) (Drs Bischoff-Ferrari and Theiler), Vontobel Foundation (Dr Bischoff-Ferrari), Baugarten Foundation (Dr Bischoff-Ferrari), and Swiss National Foundations professorship grant PP00B- 114864 (Dr Bischoff-Ferrari).

Author information

Author notes

  1. K. Renerts and K. Fischer have contributed equally to this work.

Authors and Affiliations

  1. Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, RAE B1, Rämistrasse 100, 8091, Zurich, Switzerland

    K. Renerts, K. Fischer, G. Freystaetter, A. Egli, R. Theiler & H. A. Bischoff-Ferrari

  2. Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland

    K. Renerts, K. Fischer, G. Freystaetter, A. Egli, R. Theiler & H. A. Bischoff-Ferrari

  3. Centre for Senior Trauma Care, University Hospital Zurich, Zurich, Switzerland

    K. Renerts, G. Freystaetter, H.-P. Simmen, H.-C. Pape, R. Theiler & H. A. Bischoff-Ferrari

  4. Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA

    B. Dawson-Hughes & E. J. Orav

  5. Department of Biostatistics, Harvard School of Public Health, Boston, USA

    H.-P. Simmen & H.-C. Pape

  6. Department of Traumatology, University Hospital Zurich, Zurich, Switzerland

    K. Renerts, K. Fischer, B. Dawson-Hughes, E. J. Orav, G. Freystaetter, H.-P. Simmen, H.-C. Pape, A. Egli, R. Theiler & H. A. Bischoff-Ferrari

  7. University Clinic for Acute Geriatric Care, City Hospital Waid, Zurich, Switzerland

    H. A. Bischoff-Ferrari

Authors
  1. K. Renerts
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  2. K. Fischer
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  3. B. Dawson-Hughes
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  4. E. J. Orav
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  5. G. Freystaetter
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  7. H.-C. Pape
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  8. A. Egli
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  9. R. Theiler
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  10. H. A. Bischoff-Ferrari
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Correspondence to H. A. Bischoff-Ferrari.

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Renerts, K., Fischer, K., Dawson-Hughes, B. et al. Effects of a simple home exercise program and vitamin D supplementation on health-related quality of life after a hip fracture: a randomized controlled trial. Qual Life Res 28, 1377–1386 (2019). https://doi.org/10.1007/s11136-019-02100-4

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  • DOI: https://doi.org/10.1007/s11136-019-02100-4

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