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Health-related quality of life after hip fracture: effects of a 12-month home-based exercise intervention—secondary analyses of an RCT

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Abstract

Purpose

In this randomized controlled trial, we analyzed the effects of a 12-month home-based exercise intervention on the health-related quality of life (HRQoL) of patients with a hip fracture.

Methods

Participants (n = 121) aged ≥ 60 years, with a Mini-Mental State Examination (MMSE) score of ≥ 12 and an operated hip fracture, were placed into Exercise (n = 61) or Usual care (n = 60) groups. Physiotherapist-supervised, home-based training was given twice a week over 12 months. HRQoL was assessed using the 15D instrument at baseline and at 3, 6, and 12 months. The total 15D scores and dimension scores were analyzed and compared to national age- and sex-matched reference data.

Results

The participants’ mean age was 81 years (SD 7), 75% were women, and 61% had a femoral neck fracture. The mean within-group change in total 15D score over 12 months was 0.023 (95% CI: −0.003 to 0.048) in the Usual care group, and 0.028 (CI: 0.003 to 0.054) in the Exercise group (between-group p = 0.76). We found a statistically significant change in total 15D score in the Exercise group, as well as in the dimension scores of mobility and usual activities in both groups. All 15D scores remained below the general population reference level.

Conclusion

Exercise training for 12 months did not enhance the HRQoL of home-dwelling patients with hip fractures any more than usual care. In addition, HRQoL remained below the population level in both groups.

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Acknowledgements

We thank our participants, Ms. Kaija Paajanen, RN, Ms. Virpi Äärimaa, LPN, and the personnel of Eksote for taking part in the recruitment and implementation of the trial.

Funding

This work was supported by the South Karelia Social and Health Care District (Eksote; Grant Number 1236/00.01.05.01/2013); The Social Insurance Institution of Finland (Kela; Grant Numbers 94/331/2013 and 17/26/2019), and the State Research Funding for Academic Health Research (Ministry of Social Affairs and Health, through Helsinki University Hospital (HUS)), (Grant Numbers HUS 2016 (no grant number assigned), HUS/2931/2017, HUS/2571/2017, HUS/2631/2019, 864/2020), Finland. The funders played no role in the design of the study, the choice of methods, participant recruitment, data collection, the analysis or interpretation of the data, nor in the preparation of this manuscript.

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Authors and Affiliations

  1. Rehabilitation, South Karelia Social and Health Care District (Eksote), Valto Käkelän Katu 14D, 53130, Lappeenranta, Finland

    Paula K. Soukkio, Sara A. Suikkanen, Katriina T. Kukkonen-Harjula & Markku T. Hupli

  2. Development Services, Wellbeing Services County of South Karelia, Valto Käkelän Katu 14D, 53130, Lappeenranta, Finland

    Paula K. Soukkio

  3. Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Rautpohjankatu 8, 40700, Jyväskylä, Finland

    Paula K. Soukkio & Sarianna Sipilä

  4. Faculty of Health Care and Social Services, LAB University of Applied Sciences, Yliopistonkatu 36, 53850, Lappeenranta, Finland

    Sara A. Suikkanen

  5. Department of Public Health, University of Helsinki, PO Box 20, 00014, Helsinki, Finland

    Harri Sintonen

  6. Primary Health Care Unit, Kuopio University Hospital, PO BOX 100, 70029 KYS, Kuopio, Finland

    Hannu Kautiainen

  7. Folkhälsan Research Center, Haartmaninkatu 8, 00290, Helsinki, Finland

    Hannu Kautiainen

  8. Raatimiehet Oy, Raatimiehenkatu 18, 53100, Lappeenranta, Finland

    Sanna M. Kääriä

  9. Institute of Rehabilitation, JAMK University of Applied Sciences, Piippukatu 2, 40100, Jyväskylä, Finland

    Eeva M. Aartolahti

  10. Department of General Practice, University of Helsinki, Tukholmankatu 8 B, 00290, Helsinki, Finland

    Kaisu H. Pitkälä

  11. Unit of Primary Health Care, Helsinki University Hospital, Tukholmankatu 8 B, 00290, Helsinki, Finland

    Kaisu H. Pitkälä

Authors
  1. Paula K. Soukkio
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  2. Sara A. Suikkanen
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  3. Harri Sintonen
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  4. Katriina T. Kukkonen-Harjula
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  5. Hannu Kautiainen
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  6. Sanna M. Kääriä
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  7. Markku T. Hupli
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  8. Eeva M. Aartolahti
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  9. Kaisu H. Pitkälä
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Contributions

Hupli, Kääriä, Kukkonen-Harjula, Soukkio and Suikkanen contributed to the funding applications. The concept and design of this study were developed by all the authors. Soukkio and Suikkanen acquired the participants and data. Kautiainen, Soukkio, Suikkanen and Kukkonen-Harjula conducted the statistical analyses. The first draft of the manuscript was written by Soukkio, and all the authors commented on following versions of the manuscript. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Paula K. Soukkio.

Ethics declarations

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the HUS (Helsinki University Hospital) Regional Committee on Medical Research Ethics on November 12, 2014.

Consent to participate

Informed consent was obtained from each individual study participant.

Consent for publication

As our manuscript does not include any individual person’s data in any form (including any individual details, images or videos), no consent to publish was required.

Conflict of interest

Authors Aartolahti, Kääriä, Pitkälä, Sipilä, and Kautiainen declare no conflicts of interest. Hupli was the Principal Investigator of the study and received research funds from The Social Insurance Institution of Finland (SII), and the Ministry of Social Affairs and Health (the State Research Funding for Academic Health Research, through Helsinki University Hospital (HUS), Finland). Soukkio received research funds from the State Research Funding for Academic Health Research, and from the South Karelia Social and Health Care District (Eksote), and Suikkanen from Eksote. Hupli, Kukkonen-Harjula, Soukkio, and Suikkanen have been employed by the study implementer and financier, Eksote, Finland. Sintonen is the developer of the 15D and obtains royalties from its electronic versions.

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Soukkio, P.K., Suikkanen, S.A., Sintonen, H. et al. Health-related quality of life after hip fracture: effects of a 12-month home-based exercise intervention—secondary analyses of an RCT. Qual Life Res 33, 541–550 (2024). https://doi.org/10.1007/s11136-023-03545-4

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