Objectives: Determine the feasibility of allied health assistant (AHA) management of people with hip fracture an acute hospital.
Design: Assessor-blind, parallel, feasibility randomised controlled trial with qualitative component.
Setting: Acute orthopaedic ward.
Participants: People with surgically-managed hip fracture, who walked independently pre-fracture and had no cognitive impairment.
Interventions: Rehabilitation from an AHA, under the supervision of a physiotherapist, compared with rehabilitation from a physiotherapist.
Main Outcome Measures: Feasibility was evaluated according to focus areas of demand, acceptability, practicality and implementation. Secondary outcomes included estimates of effect of adherence to hip fracture mobilisation guidelines, discharge destination, 30-day readmission, functional activity, and length of stay.
Results: Fifty people were allocated to receive rehabilitation from an AHA (n = 25) or physiotherapist (n = 25). AHA rehabilitation had high demand with 60% of eligible participants recruited. Satisfaction with AHA rehabilitation was comparable with physiotherapy rehabilitation (acceptability). The AHA group received an average of 11 min (95% CI 4 to 19) more therapy per day than the physiotherapy group (implementation). The AHA group may have had lower cost of acute care (MD -$3 808 95% CI -7 651 to 35) and adverse events were comparable between groups (practicality). The AHA group may have been 22% (HR 1.22, 95% CI 0.92 to 1.61) more likely to walk on any day and may have had a shorter length of stay (MD -0.8 days, 95% CI -2.3 to 0.7).
Conclusions: AHA management of patients with hip fracture was feasible and may improve adherence to mobilisation guidelines and reduce cost of care and length of stay.
Clinical Trial Registration Number: ACTRN12620000877987. CONTRIBUTION OF THE PAPER.
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