Dr. Craik, Dr. Mangione Publish on PT Intervention for Hip Fractures

By Caitlin Burns | October 1, 2019

Dr. Rebecca Craik and Dr. Kate Mangione

Each year, 300,000 Americans suffer a hip fracture and struggle to return to the ambulatory activities they enjoyed prior to it. 

Dr. Rebecca Craik, dean of the College of Health Sciences, and Dr. Kate Mangione, professor of Physical Therapy, recently co-published the study “Effect of a Multicomponent Home-Based Physical Therapy Intervention on Ambulation After Hip Fracture in Older Adults,” along with researchers from the University of Maryland, University of Connecticut and Dartmouth College, in the Journal of the American Medical Association.

Dr. Craik served as Co-Principal Investigator (Co-PI) on the study, which used two types of home-based interventions and discovered that, while these treatments were effective in helping some individuals regain their ability to walk, there was no significant difference between the two groups. The study results did not suggest that one treatment was superior to the other treatment. 

“Although a hip fracture is simply a broken bone, it has a huge impact for the older adult,” said Dr. Craik. “Only 50 percent of patients who were able to walk independently prior to hip fracture recover the ability to participate in their lives in the same way. The hypothesis for the study was  that more targeted physical therapy would lead to more individuals returning to community ambulation than a less focused exercise program.”

The study involved 210 participants who are 60 and older and recovering from hip fractures. One group received aerobic, strength, and balance training. The other group received nerve stimulation and active range of motion exercises. Both groups received as many as three regular weekly home visits from a physical therapist over a 16-week period. In addition, the participants received nutritional counseling and daily vitamin D, calcium, and multivitamin supplements.

The study examined if participating patients recovered “community ambulation,” which is the ability to cross the street before the traffic light changes. To determine this, participants were timed to see if they could walk 300 meters in a six-minute period after the treatment. Researchers found that the weekly in-home interventions that combined aerobic, strength, and balance training led to 23 percent of participants walking more than 300 meters in six minutes. Only 18 percent of participants of the second group, who received nerve stimulation and range of motion exercises, completed the same challenge.

“I think we learned that recovery is complicated,” said Dr. Mangione, who oversaw the design and implementation of the physical therapy interventions. “While both interventions improved performance in older adults, we need to determine why some people responded so positively to the interventions and others appeared to have little benefit from the intervention.”

The study was supported by the National Institutes of Health (NIH) grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Aging (NIA) in a grant for more than $10 million, of which Arcadia received a sub-award of $1,680,259.