医学
坠落(事故)
物理疗法
临床试验
髋部骨折
健康
害怕跌倒
随机对照试验
骨质疏松症
萧条(经济学)
物理医学与康复
毒物控制
伤害预防
内科学
精神科
医疗急救
心理干预
经济
宏观经济学
作者
Rafael Prieto‐Moreno,Pablo Molina‐García,Marta Mora‐Traverso,Mariana Ortiz‐Piña,Susana Salazar‐Graván,V. Cruz Guisado,R. Del Pino Algarrada,Miguel Martín‐Matillas,Fernando Estévez‐López,Patrocinio Ariza‐Vega
标识
DOI:10.1136/annrheumdis-2023-eular.5548
摘要
Background
Osteoporotic hip fracture causes a high level of dependency in older adults, as their functional status suddenly decreases greatly. In addition, the high level of pain and the fear of falling that they frequently experience maintain this decrease in functional status for a longer period. Digital health, the promotion of health through the use of Information and Communication Technologies, emerges as an option for the rehabilitation of older adults with hip fracture. Objectives
To test the effectiveness of the co-created ActiveHip+ mHealth system on the recovery of the functional status and the decrease of the pain and fear of falling in older adults with hip fracture. Methods
A total of 110 older adults with hip fracture and their family caregivers were recruited from hospitals in southern Spain. Participants were randomly assigned to an intervention group (n = 55), in which rehabilitation was performed through ActiveHip+, or to a control group (n = 55), in which they received standard rehabilitation for a hip fracture from the Andalusian Public Health System. Participants were assessed during the hospital stay and 3 months after surgery. Feasibility assessment was done through adoption (participation proportion), usage (access to the app), satisfaction with the app (Net Promoter Score) and user perception of the quality of the app (Mobile App Rating Scale). Clinical assessment was conducted through patient-reported outcomes, such as the Functional Independence Measure and the New Mobility Score Spanish version for functional status, the Numerical Rating Scale for pain and the Short Falls Efficacy Scale-International for fear of falling. Results
We obtained positive results in terms of feasibility as we observed 88% adoption, 82% usage, 8.35/10 in satisfaction with the app and 4.3/5 in perceived quality of the app.The functional status of patients allocated to the intervention group (those using ActiveHip+) had a statistically significant greater recovery than participants of the control group at 3-months (medium effect size: 0.70 Cohen's d; p = 0.02) and (medium effect size: 0.62 Cohen's d; p = 0.03) respectively. In addition, the level of pain was statistically significant lower in participants of the intervention group than those in the control group (medium effect size: 0.45; Cohen's d p = 0.03). Regarding the fear of falling, there was no statistically significant difference (medium effect size: 0.32 Cohen's d; p = 0.17). Conclusion
The ActiveHip+ mHealth system is effective in the recovery of the functional status and the decrease of pain in older adults with hip fracture. However, it was not effective on the decrease of the fear of falling. REFERENCES:
NIL. Acknowledgements:
NIL. Disclosure of Interests
None Declared.
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