Health-related quality of life and self-reported ability concerning ADL and IADL after hip fracture: a randomized trial.

Background: It is not known whether postoperative occupational therapy is of value for hip fracture patients. In this randomized trial we evaluated the effects of an individualized, postoperative, occupational training (OT) program on the patient's self-reported health-related quality of life (HRQL) and self-reported abilities to perform activities of daily living (ADL) and instrumental activities of daily living (IADL).

Patients And Methods: 100 eligible patients (aged >or= 65 years) were randomized 50:50 to an OT or control group (termed the C group: conventional care). The OT group received individualized OT from day 3 or 4 after surgery and until discharge, and also a home visit. The patients answered the Swedish Health-Related Quality of Life questionnaire (SWED-QUAL) and the modified Disability Rating Index (DRI) three times: 3-4 days after surgery, at discharge, and at follow-up after 2 months.

Results: We found no statistically significant differences between the groups at discharge and at follow-up regarding mean SWED-QUAL scores. However, on comparing each group over time, 2 months after the fracture the OT group had regained their self-reported pre-fracture HRQL status in 10 of 12 SWED-QUAL subscales, and the C group in 6 subscales. Statistically significant differences (p < 0.05) were found between the groups after 2 months regarding self-reported IADL (moving around indoors, performance of light housework, and getting in and out of a car).

Interpretation: Our findings indicate that the individualized occupational training improved the ability to perform IADL and appeared to speed up the recovery in some HRQL areas.