Improvement in aerobic fitness during rehabilitation after hip fracture

Objective: To evaluate the effect of an upper-body exercise program on cardiorespiratory fitness in older adults with hip fracture during inpatient rehabilitation. Design: Randomized controlled trial using a convenience sample. Setting: An inpatient rehabilitation unit. Participants: Twenty older patients (age, 81.3 +/- 7.2y; 14 women). Intervention: Patients were randomly assigned to a control group (n=10) or a training group (n=10). Both groups attended physical and occupational therapy sessions 5 times a week during rehabilitation (mean length of stay, 32.9 +/- 5.3d). Patients in the training program used an arm crank ergometer 3 times a week for 4 weeks. Main Outcome Measure: Peak oxygen consumption (Vo(2)peak). Results: Vo(2)peak increased significantly in the training group (8.9 +/- 1.4 to 10.8 +/- 1.7mL(.)kg(-1.)min(-1)) and did not change in the control group (8.9 +/- 1.2 to 8.8 +/- 1.6mL(.)kg(-1.)min(-1)). At discharge, both groups were significantly improved in all functional outcome measures (Timed Up & Go [TUG] test, Berg Balance Scale [BBS], FIM instrument, two-minute walk test [2MWT], and ten-minute walk test [10MWT]). The training group performed significantly better in mobility (TUG, 2MWT, 10MWT) and balance (BBS) compared with the control group. There was a significant correlation between Vo(2)peak and the 2MWT (r=.81) and 10MWT (r=.85) in the training group at discharge. Conclusions: The upper-body exercise program had a significant effect on aerobic power. Our results suggest that aerobic endurance exercise should be integrated into standard rehabilitation to enhance patients' aerobic fitness and mobility after hip fracture surgery.