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Effectiveness of a physical therapist-directed home exercise program in elderly patients post-hip fracture surgery in a low-resource setting: A retrospective cohort study

Year: 2025

Type: article

Abstract: To evaluate the effectiveness of a four-week physical therapist-directed home exercise program versus usual care in elderly patients after hip fracture surgery. This retrospective cohort study was conducted in Thailand (July 2022–May2023) among 30 patients aged 60–90 years who underwent hip fracture surgery. Participants were assigned based on residence to a home exercise group ( n = 15), receiving biweekly home visits from physical therapists, or a usual care group (n = 15), receiving exercise leaflets. Functional outcomes—Short Physical Performance Battery (SPPB), 2-Minute Walk Test (2MWT), Modified Functional Ambulation Category (FAC), and Katz Activities of Daily Living (ADL) Index—were assessed at discharge and after four weeks. Both groups improved significantly on all outcomes ( p < 0.05). The home exercise group showed greater median improvement in SPPB scores than usual care (3 points; 95 % CI: 1.1–4.9; p = 0.002), surpassing the minimal clinically important difference. No significant differences were observed for 2MWT, FAC, or Katz ADL. Adherence to the home program was moderate (62.5 %), with higher adherence linked to greater SPPB gains. A four-week therapist-directed home exercise program is feasible and more effective than usual care in improving lower extremity function in elderly post-hip fracture patients. This approach is a viable option in resource-limited settings to enhance early recovery. • Four-week home PT program improves mobility after hip fracture surgery in elderly • Therapist-led rehab yields greater functional gains than usual care post-discharge • Moderate adherence (62.5 %) still results in clinically meaningful recovery benefits • Study demonstrates feasibility of early home rehab in low-resource clinical settings • Arthroplasty patients showed slightly greater functional improvement than fixation group.

Source: Experimental Gerontology

DOI: 10.1016/j.exger.2025.112949