TY - JOUR
T1 - Effects of the FIT-HIP Intervention for Fear of Falling After Hip Fracture
T2 - A Cluster-Randomized Controlled Trial in Geriatric Rehabilitation
AU - Scheffers-Barnhoorn, Maaike N.
AU - van Eijk, Monica
AU - van Haastregt, Jolanda C. M.
AU - Schols, Jos M. G. A.
AU - van Balen, Romke
AU - van Geloven, Nan
AU - Kempen, Gertrudis I. J. M.
AU - Achterberg, Wilco P.
PY - 2019/7
Y1 - 2019/7
N2 - Objectives: Fear of falling (FoF) is common after hip fracture and can impede functional recovery because of activity restriction. The Fear of falling InTervention in HIP fracture geriatric rehabilitation (FIT-HIP intervention) was designed to target FoF and consequently to improve mobility. The aim of this study was to evaluate the effect of the FIT-HIP intervention in patients with FoF in geriatric rehabilitation (GR) after hip fracture.Design, setting, and participants: This cluster-randomized controlled trial was performed in 11 post-acute GR units in the Netherlands (2016-2017). Six clusters were assigned to the intervention group, 5 to the usual care group. We included 78 patients with hip fracture and FoF (aged >= 65 years; 39 per group).Intervention(s): The FIT-HIP intervention is a multicomponent cognitive behavioral intervention conducted by physiotherapists, embedded in usual care in GR. The FIT-HIP intervention was compared to usual care in GR.Measurements: FoF was assessed with the Falls Efficacy Scale-International (FES-I) and mobility, with the Performance Oriented Mobility Assessment (POMA). Data were collected at baseline, discharge, and 3 and 6 months postdischarge from GR. Primary endpoints were change scores at discharge. Linear mixed models were used to evaluate the treatment effect.Results: No significant between-group differences were observed for primary outcome measures. With the usual care group as reference, the FES-I estimated difference between mean change scores was 3.3 [95% confidence interval (CI) -1.0, 7.5, P = .13] at discharge from GR; -4.1 (95% CI -11.8, 3.6, P = .29) after 3 months; and -2.8 (95% CI -10.0, 4.4, P = .44) after 6 months. POMA estimated difference was -0.3 (95% CI -6.5, 5.8, P = .90).Conclusion/Implications: The FIT-HIP intervention was not effective in reducing FoF. Possibly FoF (shortly) after hip fracture can to some extent be appropriate. This may imply the study was not able to accurately identify and accordingly treat FoF that is maladaptive (reflective of disproportionate anxiety). (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
AB - Objectives: Fear of falling (FoF) is common after hip fracture and can impede functional recovery because of activity restriction. The Fear of falling InTervention in HIP fracture geriatric rehabilitation (FIT-HIP intervention) was designed to target FoF and consequently to improve mobility. The aim of this study was to evaluate the effect of the FIT-HIP intervention in patients with FoF in geriatric rehabilitation (GR) after hip fracture.Design, setting, and participants: This cluster-randomized controlled trial was performed in 11 post-acute GR units in the Netherlands (2016-2017). Six clusters were assigned to the intervention group, 5 to the usual care group. We included 78 patients with hip fracture and FoF (aged >= 65 years; 39 per group).Intervention(s): The FIT-HIP intervention is a multicomponent cognitive behavioral intervention conducted by physiotherapists, embedded in usual care in GR. The FIT-HIP intervention was compared to usual care in GR.Measurements: FoF was assessed with the Falls Efficacy Scale-International (FES-I) and mobility, with the Performance Oriented Mobility Assessment (POMA). Data were collected at baseline, discharge, and 3 and 6 months postdischarge from GR. Primary endpoints were change scores at discharge. Linear mixed models were used to evaluate the treatment effect.Results: No significant between-group differences were observed for primary outcome measures. With the usual care group as reference, the FES-I estimated difference between mean change scores was 3.3 [95% confidence interval (CI) -1.0, 7.5, P = .13] at discharge from GR; -4.1 (95% CI -11.8, 3.6, P = .29) after 3 months; and -2.8 (95% CI -10.0, 4.4, P = .44) after 6 months. POMA estimated difference was -0.3 (95% CI -6.5, 5.8, P = .90).Conclusion/Implications: The FIT-HIP intervention was not effective in reducing FoF. Possibly FoF (shortly) after hip fracture can to some extent be appropriate. This may imply the study was not able to accurately identify and accordingly treat FoF that is maladaptive (reflective of disproportionate anxiety). (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
KW - Fear of falling
KW - hip fracture
KW - geriatric rehabilitation
KW - cognitive behavioral therapy
KW - randomized controlled trial
KW - OLDER-PEOPLE
KW - FUNCTIONAL RECOVERY
KW - MANAGE CONCERNS
KW - REDUCE FEAR
KW - PREVALENCE
KW - PROGRAM
KW - PERFORMANCE
KW - AVOIDANCE
KW - DISCHARGE
KW - EFFICACY
U2 - 10.1016/j.jamda.2019.03.009
DO - 10.1016/j.jamda.2019.03.009
M3 - Article
C2 - 31078486
VL - 20
SP - 857
EP - 865
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
SN - 1525-8610
IS - 7
ER -