Effects of a simple home exercise program and vitamin D supplementation on health-related quality of life after a hip fracture: a randomized controlled trial.

Autor: Renerts K; Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, RAE B1, Rämistrasse 100, 8091, Zurich, Switzerland.; Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland.; Centre for Senior Trauma Care, University Hospital Zurich, Zurich, Switzerland.; Department of Traumatology, University Hospital Zurich, Zurich, Switzerland., Fischer K; Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, RAE B1, Rämistrasse 100, 8091, Zurich, Switzerland.; Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland.; Department of Traumatology, University Hospital Zurich, Zurich, Switzerland., Dawson-Hughes B; Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.; Department of Traumatology, University Hospital Zurich, Zurich, Switzerland., Orav EJ; Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.; Department of Traumatology, University Hospital Zurich, Zurich, Switzerland., Freystaetter G; Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, RAE B1, Rämistrasse 100, 8091, Zurich, Switzerland.; Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland.; Centre for Senior Trauma Care, University Hospital Zurich, Zurich, Switzerland.; Department of Traumatology, University Hospital Zurich, Zurich, Switzerland., Simmen HP; Centre for Senior Trauma Care, University Hospital Zurich, Zurich, Switzerland.; Department of Biostatistics, Harvard School of Public Health, Boston, USA.; Department of Traumatology, University Hospital Zurich, Zurich, Switzerland., Pape HC; Centre for Senior Trauma Care, University Hospital Zurich, Zurich, Switzerland.; Department of Biostatistics, Harvard School of Public Health, Boston, USA.; Department of Traumatology, University Hospital Zurich, Zurich, Switzerland., Egli A; Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, RAE B1, Rämistrasse 100, 8091, Zurich, Switzerland.; Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland.; Department of Traumatology, University Hospital Zurich, Zurich, Switzerland., Theiler R; Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, RAE B1, Rämistrasse 100, 8091, Zurich, Switzerland.; Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland.; Centre for Senior Trauma Care, University Hospital Zurich, Zurich, Switzerland.; Department of Traumatology, University Hospital Zurich, Zurich, Switzerland., Bischoff-Ferrari HA; Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, RAE B1, Rämistrasse 100, 8091, Zurich, Switzerland. Heike.Bischoff@usz.ch.; Centre on Aging and Mobility, University Hospital Zurich and City Hospital Waid, Zurich, Switzerland. Heike.Bischoff@usz.ch.; Centre for Senior Trauma Care, University Hospital Zurich, Zurich, Switzerland. Heike.Bischoff@usz.ch.; Department of Traumatology, University Hospital Zurich, Zurich, Switzerland. Heike.Bischoff@usz.ch.; University Clinic for Acute Geriatric Care, City Hospital Waid, Zurich, Switzerland. Heike.Bischoff@usz.ch.
Jazyk: angličtina
Zdroj: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation [Qual Life Res] 2019 May; Vol. 28 (5), pp. 1377-1386. Date of Electronic Publication: 2019 Feb 09.
DOI: 10.1007/s11136-019-02100-4
Abstrakt: Purpose: To test the effects of vitamin D intervention and a simple home exercise program (HE) on health-related quality of life (HRQL) in the first 12 months after hip fracture.
Methods: HRQL was reported in 173 acute hip fracture patients (mean age 84 years, 79% females, 77% community dwelling) who were enrolled in the 12-month 2 × 2 factorial Zurich Hip Fracture Trial. Pre-fracture HRQL was assessed at baseline (4.2 ± 2.2 days post-surgery) and then again at 6 and 12 months after hip fracture surgery by the EuroQol EQ-5D-3L index value (EQ-5D-3L questionnaire). The effects of vitamin D intervention (2000 vs. 800 IU vitamin D 3 ) and exercise (HE vs. no HE) or of the combined interventions on HRQL were assessed using multivariable-adjusted repeated-measures linear mixed-effects regression models.
Results: The EQ-5D-3L index value significantly worsened from 0.71 pre-fracture to 0.57 over 12 months, but the degree of worsening did not differ between individual or combined interventions. However, regarding only the late recovery between 6 and 12 months, the group receiving neither intervention (800 IU/day and no HE) experienced a significant further decline in the EQ-5D-3L index value (adjusted mean change = 0.08 [95% CI 0.009, 0.15], p = 0.03) while all other groups remained stable.
Conclusion: Hip fractures have a long-lasting negative effect on HRQL up to 12 months after hip fracture. However, HE and/or 2000 IU vitamin D per day may help prevent a further decline in HRQL after the first 6 months following the acute hip fracture event.
Databáze: MEDLINE
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