Body Weight Supported Treadmill Training Following Hip Fracture
Body Weight Supported Treadmill Training Following Hip Fracture
Achieving independent ambulation is an important goal of hip fracture rehabilitation, as it
 is predictive of returning to the community and of future health problems. Current research
 regarding post-hip fracture rehabilitation is sparse. Body weight supported treadmill
 training (BWSTT) is a novel approach to retrain walking abilities. BWSTT may be ideal for
 retraining walking after hip fracture, as it is task-specific and alleviates the demands of
 maintaining balance while walking skills are trained. The use of the harness may provide a
 sense of security for the patient, facilitating walking training. The proposed project will
 investigate the feasibility and tolerability of BWSTT after hip fracture, and its impact on
 function, mobility, quality of life and fear of falling. It is hypothesized that BWSTT 3-5
 times weekly in acute hip fracture patients will improve function, mobility, quality of life
 and reduce fear of falling.
Morbidity and mortality rates associated with hip fracture are enormous. Current literature
 regarding post-hip fracture rehabilitation is sparse. A recent Cochrane review suggested that
 the potential for enhancing the recovery of mobility in hip fracture patients with treadmill
 gait retraining warrants further research in this area. Body weight supported treadmill
 training (BWSTT) is a novel approach to retraining ambulation, and has been successfully
 implemented in other patient populations. BWSTT may be ideal for retraining gait after hip
 fracture, as it is task-specific and alleviates the demands of maintaining equilibrium while
 walking skills are trained. The objectives of the proposed pilot study are to evaluate the
 feasibility and tolerability of using BWSTT as a gait retraining strategy in individuals who
 have experienced a hip fracture, and to explore whether it can improve mobility, fear of
 falling and function. Participants' feedback will be sought regarding the BWSTT experience
 for use in planning future clinical trials, to be submitted to CIHR. Quantitative outcomes
 will be assessed at baseline, and after 4 weeks of training 3-5 times per week. Outcome
 measures include: the Lower Extremity Functional Scale, health-related quality of life
 (SF-36), Falls-Efficacy Scale and the 2-minute walk test. Based on previous research
 experience with the frail elderly, we anticipate that many patients will be receptive to
 rehabilitation in the form of BWSTT. We hypothesize that BWSTT after hip fracture will result
 in significant gains in ambulatory capacity, as well as improvements in quality of life and
 functional independence. In addition, we anticipate that BWSTT will prove to be a feasible
 and effective gait retraining strategy.
Inclusion Criteria:

 -  Able to follow 2-step commands

 -  Stable inter-trochanteric fracture, where fixation is deemed by surgeon to be
 adequate, OR sub-capital fracture having undergone bipolar hemi-arthroplasty

 -  Able to stand and take a few steps with the help of an assistive device i.e. parallel
 bars, walker, or cane

 Exclusion Criteria:

 -  Able to walk without assistive devices

 -  Hip, knee or ankle surgery prior to hip fracture

 -  Inability to understand instructions or give informed consent

 -  Uncontrolled cardiovascular disease or hypertension, diabetes, neuromuscular disease
 or other musculoskeletal disease such as rheumatoid arthritis, Uncontrolled pain