Date of Award

6-2016

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not homebased therapy is effective for restoring functional abilities in patients over sixty with a primary hip fracture.

STUDY DESIGN: This review consists of two RCTs and one randomized clinical trial published in the English language between the years 2014 and 20 15.

DATA SOURCES: Articles were published in peer reviewed journals and compared home-based therapy as an intervention following a primary hip fracture to individuals solely documentation of post-surgical care using Cochrane and PubMed databases.

OUTCOMES MEASURED: The specific outcomes measured varied between articles but all focused on patient functional improvements. Edgren et al. focused on ADLs and IADLs sum scores, Latham et al. used SPPB and AM-PAC to measure balance, gait, speed, mobility, and function, while Salposki et al. used patient perceived ability to climb stairs, SPPB, and BBT.

RESULTS: All three studies had positive outcomes following the intervention with varying degrees of statistical significance. Latham et al. had significant results regarding gait, speed, and balance using the SPPB (p

CONCLUSIONS: The results of the RCTs and randomi zed clinical trial suggest there may be a benefit in recovery with the intervention of home-based therapy following a primary hip fracture in those over 60. Although every study did not have statistical significance, all studies did show improvement in the intervention groups when compared to the control. Further research is needed to determine the length or types of home-based therapy that should be implemented. The studies could be improved by determining the most effective forms of therapy and by measuring functional abilities and confidence levels prior to hip fracture, following the hip fracture, and following the interventions.

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