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.
N1 - Funding Information:
This work was supported by ZonMw (The Netherlands Organization for Health Research and Development; research grant number 839120004). This study has been conducted independently of the funding body. SBOH (employer of elderly care medicine trainees)and the Leiden University Medical Center (training center for older elderly medicine)additionally support this study. The authors express their gratitude to Bart Beck, health care psychologist, cognitive behavioral therapist and teacher at LUMC, for his assistance in developing the intervention, providing training to the intervention physiotherapists and psychologists, and his contribution to the interpretation of the findings. Thankfully, Eve Dumas and Eva van der Ploeg (both psychologists)were involved in designing the intervention and Frans van Wijngaarden (physiotherapist)was involved in training the research assistants in the physical assessments. We also thank our team of independent research assistants for their crucial role in enrollment/inclusion and data acquisition (Wilma van der Schrier, Olga Weeda, and Anita Pannekoek). In addition, we thank all participants and also the participating post-acute geriatric rehabilitation units and their staff for participating in the study, assisting with screening, and conducting the intervention. This study was performed within the University Network for the Care Sector South Holland in the Netherlands (UNC-ZH)(Reference: Achterberg WP, Caljouw MAA, Husebo BS. Towards academic nursing home medicine: A Dutch example for Norway? OMSORG 2015;1:10-15).
Funding Information:
This work was supported by ZonMw (The Netherlands Organization for Health Research and Development ; research grant number 839120004 ). This study has been conducted independently of the funding body. SBOH (employer of elderly care medicine trainees) and the Leiden University Medical Center (training center for older elderly medicine) additionally support this study.
Funding Information:
This work was supported by ZonMw (The Netherlands Organization for Health Research and Development; research grant number 839120004). This study has been conducted independently of the funding body. SBOH (employer of elderly care medicine trainees) and the Leiden University Medical Center (training center for older elderly medicine) additionally support this study. This work was supported by ZonMw (The Netherlands Organization for Health Research and Development; research grant number 839120004). This study has been conducted independently of the funding body. SBOH (employer of elderly care medicine trainees) and the Leiden University Medical Center (training center for older elderly medicine) additionally support this study. The authors express their gratitude to Bart Beck, health care psychologist, cognitive behavioral therapist and teacher at LUMC, for his assistance in developing the intervention, providing training to the intervention physiotherapists and psychologists, and his contribution to the interpretation of the findings. Thankfully, Eve Dumas and Eva van der Ploeg (both psychologists) were involved in designing the intervention and Frans van Wijngaarden (physiotherapist) was involved in training the research assistants in the physical assessments. We also thank our team of independent research assistants for their crucial role in enrollment/inclusion and data acquisition (Wilma van der Schrier, Olga Weeda, and Anita Pannekoek). In addition, we thank all participants and also the participating post-acute geriatric rehabilitation units and their staff for participating in the study, assisting with screening, and conducting the intervention. This study was performed within the University Network for the Care Sector South Holland in the Netherlands (UNC-ZH) (Reference: Achterberg WP, Caljouw MAA, Husebo BS. Towards academic nursing home medicine: A Dutch example for Norway? OMSORG 2015;1:10-15). This work was supported by ZonMw (The Netherlands Organization for Health Research and Development; research grant number 839120004). This study has been conducted independently of the funding body. SBOH (employer of elderly care medicine trainees) and the Leiden University Medical Center (training center for older elderly medicine) additionally support this study.
Publisher Copyright:
© 2019 AMDA – The Society for Post-Acute and Long-Term Care Medicine
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
SN - 1525-8610
VL - 20
SP - 857-865.e2
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 7
ER -