Remember Me
Or use your Academic/Social account:


Or use your Academic/Social account:


You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.


Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message


Verify Password:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Sletvold, Olav; Helbostad, Jorunn L; Thingstad, Pernille; Taraldsen, Kristin; Prestmo, Anders; Lamb, Sarah E; Aamodt, Arild; Johnsen, Roar; Magnussen, Jon; Saltvedt, Ingvild (2011)
Publisher: BioMed Central
Journal: BMC Geriatrics
Languages: English
Types: Article
Subjects: RC, Geriatrics, Geratology, Orthopaedics, Study Protocol, Organisation and evaluation of medical care, RC952-954.6, Geriatrics and Gerontology



Hip fractures in older people are associated with high morbidity, mortality, disability and reduction in quality of life. Traditionally people with hip fracture are cared for in orthopaedic departments without additional geriatric assessment. However, studies of postoperative rehabilitation indicate improved efficiency of multidisciplinary geriatric rehabilitation as compared to traditional care. This randomized controlled trial (RCT) aims to investigate whether an additional comprehensive geriatric assessment of hip fracture patients in a special orthogeriatric unit during the acute in-hospital phase may improve outcomes as compared to treatment as usual in an orthopaedic unit.


The intervention of interest, a comprehensive geriatric assessment is compared with traditional care in an orthopaedic ward. The study includes 401 home-dwelling older persons >70 years of age, previously able to walk 10 meters and now treated for hip fracture at St. Olav Hospital, Trondheim, Norway. The participants are enrolled and randomised during the stay in the Emergency Department. Primary outcome measure is mobility measured by the Short Physical Performance Battery (SPPB) at 4 months after surgery. Secondary outcomes measured at 1, 4 and 12 months postoperatively are place of residence, activities of daily living, balance and gait, falls and fear of falling, quality of life and depressive symptoms, as well as use of health care resources and survival.


We believe that the design of the study, the randomisation procedure and outcome measurements will be of sufficient strength and quality to evaluate the impact of comprehensive geriatric assessment on mobility and other relevant outcomes in hip fracture patients.

Trials registration

ClinicalTrials.gov, NCT00667914

  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. Gjertsen JE, Engesaeter LB, Furnes O, Havelin LI, Steindal K, Vinje T, Fevang JM: The Norwegian Hip Fracture Register: experiences after the first 2 years and 15,576 reported operations. Acta Orthop 2008, 79(5):583-593.
    • 2. Bacon WE: Secular trends in hip fracture occurrence and survival: age and sex differences. J Aging Health 1996, 8(4):538-553.
    • 3. Cooper C: The crippling consequences of fractures and their impact on quality of life. Am J Med 1997, 103(2A):12S-17S, discussion 17S-19S.
    • 4. Melton LJ, Therneau TM, Larson DR: Long-term trends in hip fracture prevalence: the influence of hip fracture incidence and survival. Osteoporos Int 1998, 8(1):68-74.
    • 5. Haleem S, Lutchman L, Mayahi R, Grice JE, Parker MJ: Mortality following hip fracture: trends and geographical variations over the last 40 years. Injury 2008, 39(10):1157-1163.
    • 6. Pasco JA, Sanders KM, Hoekstra FM, Henry MJ, Nicholson GC, Kotowicz MA: The human cost of fracture. Osteoporos Int 2005, 16(12):2046-2052.
    • 7. Osnes EK, Lofthus CM, Meyer HE, Falch JA, Nordsletten L, Cappelen I, Kristiansen IS: Consequences of hip fracture on activities of daily life and residential needs. Osteoporos Int 2004, 15(7):567-574.
    • 8. Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G: Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 2004, 59(3):255-263.
    • 9. Ensrud KE, Ewing SK, Taylor BC, Fink HA, Stone KL, Cauley JA, Tracy JK, Hochberg MC, Rodondi N, Cawthon PM: Frailty and risk of falls, fracture, and mortality in older women: the study of osteoporotic fractures. J Gerontol A Biol Sci Med Sci 2007, 62(7):744-751.
    • 10. Adams AL, Schiff MA, Koepsell TD, Rivara FP, Leroux BG, Becker TM, Hedges JR: Physician consultation, multidisciplinary care, and 1-year mortality in Medicare recipients hospitalized with hip and lower extremity injuries. J Am Geriatr Soc 2010, 58(10):1835-1842.
    • 11. Arinzon Z, Fidelman Z, Zuta A, Peisakh A, Berner YN: Functional recovery after hip fracture in old-old elderly patients. Arch Gerontol Geriatr 2005, 40(3):327-336.
    • 12. Naglie G, Tansey C, Kirkland JL, Ogilvie-Harris DJ, Detsky AS, Etchells E, Tomlinson G, O'Rourke K, Goldlist B: Interdisciplinary inpatient care for elderly people with hip fracture: a randomized controlled trial. CMAJ 2002, 167(1):25-32.
    • 13. Olofsson B, Lundstrom M, Borssen B, Nyberg L, Gustafson Y: Delirium is associated with poor rehabilitation outcome in elderly patients treated for femoral neck fractures. Scand J Caring Sci 2005, 19(2):119-127.
    • 14. Lundstrom M, Edlund A, Karlsson S, Brannstrom B, Bucht G, Gustafson Y: A multifactorial intervention program reduces the duration of delirium, length of hospitalization, and mortality in delirious patients. J Am Geriatr Soc 2005, 53(4):622-628.
    • 15. Marcantonio ER, Flacker JM, Wright RJ, Resnick NM: Reducing delirium after hip fracture: a randomized trial. J Am Geriatr Soc 2001, 49(5):516-522.
    • 16. Crotty M, Unroe K, Cameron ID, Miller M, Ramirez G, Couzner L: Rehabilitation interventions for improving physical and psychosocial functioning after hip fracture in older people. Cochrane Database Syst Rev 2010, , 1: CD007624.
    • 17. Bachmann S, Finger C, Huss A, Egger M, Stuck AE, Clough-Gorr KM: Inpatient rehabilitation specifically designed for geriatric patients: systematic review and meta-analysis of randomised controlled trials. BMJ 2010, 340:c1718.
    • 18. Mak JC, Cameron ID, March LM: Evidence-based guidelines for the management of hip fractures in older persons: an update. Med J Aust 2010, 192(1):37-41.
    • 19. Pioli G, Giusti A, Barone A: Orthogeriatric care for the elderly with hip fractures: where are we? Aging Clin Exp Res 2008, 20(2):113-122.
    • 20. Saltvedt I, Mo ES, Fayers P, Kaasa S, Sletvold O: Reduced mortality in treating acutely sick, frail older patients in a geriatric evaluation and management unit. A prospective randomized trial. J Am Geriatr Soc 2002, 50(5):792-798.
    • 21. Saltvedt I, Saltnes T, Mo ES, Fayers P, Kaasa S, Sletvold O: Acute geriatric intervention increases the number of patients able to live at home. A prospective randomized study. Aging Clin Exp Res 2004, 16(4):300-306.
    • 22. Fitzgerald JF, Moore PS, Dittus RS: The care of elderly patients with hip fracture. Changes since implementation of the prospective payment system. N Engl J Med 1988, 319(21):1392-1397.
    • 23. Gehlbach SH, Avrunin JS, Puleo E: Trends in hospital care for hip fractures. Osteoporos Int 2007, 18(5):585-591.
    • 24. Godlee F: Publishing study protocols: making them visible will prove registration, reporting and recruitment. BMC News and Views 2001, 2(4).
    • 25. Ellis G, Langhorne P: Comprehensive geriatric assessment for older hospital patients. Br Med Bull 2004, 71:45-59.
    • 26. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB: A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994, 49(2):M85-94.
    • 27. Guralnik JM, Ferrucci L, Pieper CF, Leveille SG, Markides KS, Ostir GV, Studenski S, Berkman LF, Wallace RB: Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci 2000, 55(4):M221-231.
    • 28. Ostir GV, Volpato S, Fried LP, Chaves P, Guralnik JM: Reliability and sensitivity to change assessed for a summary measure of lower body function: results from the Women's Health and Aging Study. J Clin Epidemiol 2002, 55(9):916-921.
    • 29. Studenski S, Perera S, Wallace D, Chandler JM, Duncan PW, Rooney E, Fox M, Guralnik JM: Physical performance measures in the clinical setting. J Am Geriatr Soc 2003, 51(3):314-322.
    • 30. Podsiadlo D, Richardson S: The timed “Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991, 39(2):142-148.
    • 31. Helbostad JL, Sletvold O, Moe-Nilssen R: Effects of home exercises and group training on functional abilities in home-dwelling older persons with mobility and balance problems. A randomized study. Aging Clin Exp Res 2004, 16(2):113-121.
    • 32. Kristensen MT, Foss NB, Kehlet H: Timed “up & go” test as a predictor of falls within 6 months after hip fracture surgery. Phys Ther 2007, 87(1):24-30.
    • 33. Jaglal S, Lakhani Z, Schatzker J: Reliability, validity, and responsiveness of the lower extremity measure for patients with a hip fracture. J Bone Joint Surg Am 2000, 82A(7):955-962.
    • 34. Ingemarsson AH, Frandin K, Mellstrom D, Moller M: Walking ability and activity level after hip fracture in the elderly-a follow-up. J Rehabil Med 2003, 35(2):76-83.
    • 35. Mendelsohn ME, Leidl DS, Overend TJ, Petrella RJ: Specificity of functional mobility measures in older adults after hip fracture: a pilot study. Am J Phys Med Rehabil 2003, 82(10):766-774.
    • 36. Crotty M, Whitehead C, Miller M, Gray S: Patient and caregiver outcomes 12 months after home-based therapy for hip fracture: a randomized controlled trial. Arch Phys Med Rehabil 2003, 84(8):1237-1239.
    • 37. Foss NB, Kristensen MT, Kehlet H: Prediction of postoperative morbidity, mortality and rehabilitation in hip fracture patients: the cumulated ambulation score. Clin Rehabil 2006, 20(8):701-708.
    • 38. Mahoney FI, Barthel DW: Functional Evaluation: The Barthel Index. Md State Med J 1965, 14:61-65.
    • 39. Gladman JR, Lincoln NB, Adams SA: Use of the extended ADL scale with stroke patients. Age Ageing 1993, 22(6):419-424.
    • 40. Harwood RH, Ebrahim S: The validity, reliability and responsiveness of the Nottingham Extended Activities of Daily Living scale in patients undergoing total hip replacement. Disabil Rehabil 2002, 24(7):371-377.
    • 41. Brooks R: EuroQol: the current state of play. Health Policy 1996, 37(1):53-72.
    • 42. Hartrick CT, Kovan JP, Shapiro S: The numeric rating scale for clinical pain measurement: a ratio measure? Pain Pract 2003, 3(4):310-316.
    • 43. Parker M, Currie CC, Mountain JA, Thorngren K-G: Standardised audit of hip fracture in Europe (SAHFE). HIP International 1998, 8:10-15.
    • 44. Menz HB, Latt MD, Tiedemann A, Mun San Kwan M, Lord SR: Reliability of the GAITRite walkway system for the quantification of temporo-spatial parameters of gait in young and older people. Gait Posture 2004, 20(1):20-25.
    • 45. Moe-Nilssen R, Helbostad JL: Interstride trunk acceleration variability but not step width variability can differentiate between fit and frail older adults. Gait Posture 2005, 21(2):164-170.
    • 46. Helbostad JL, Leirfall S, Moe-Nilssen R, Sletvold O: Physical fatigue affects gait characteristics in older persons. J Gerontol A Biol Sci Med Sci 2007, 62(9):1010-1015.
    • 47. Grant PM, Ryan CG, Tigbe WW, Granat MH: The validation of a novel activity monitor in the measurement of posture and motion during everyday activities. Br J Sports Med 2006, 40(12):992-997.
    • 48. Taraldsen K, Askim T, Sletvold O, Einarsen EK, Gruner Bjastad K, Indredavik B, Helbostad JL: Evaluation of a Body-Worn Sensor System to Measure Physical Activity in Older People With Impaired Function. Phys Ther 2011.
    • 49. Friedman SM, Munoz B, West SK, Rubin GS, Fried LP: Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatr Soc 2002, 50(8):1329-1335.
    • 50. Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C: Development and initial validation of the Falls Efficacy ScaleInternational (FES-I). Age Ageing 2005, 34(6):614-619.
    • 51. Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL: A new clinical scale for the staging of dementia. Br J Psychiatry 1982, 140:566-572.
    • 52. Folstein MF, Folstein SE, McHugh PR: “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975, 12(3):189-198.
    • 53. Sheikh JI, Yesavage JA, Brooks JO, Friedman L, Gratzinger P, Hill RD, Zadeik A, Crook T: Proposed factor structure of the Geriatric Depression Scale. Int Psychogeriatr 1991, 3(1):23-28.
    • 54. Vinkers DJ, Gussekloo J, Stek ML, Westendorp RG, Van Der Mast RC: The 15- item Geriatric Depression Scale (GDS-15) detects changes in depressive symptoms after a major negative life event. The Leiden 85-plus Study. Int J Geriatr Psychiatry 2004, 19(1):80-84.
    • 55. Koehler M, Rabinowitz T, Hirdes J, Stones M, Carpenter GI, Fries BE, Morris JN, Jones RN: Measuring depression in nursing home residents with the MDS and GDS: an observational psychometric study. BMC Geriatr 2005, 5:1.
    • 56. Jongenelis K, Pot AM, Eisses AM, Gerritsen DL, Derksen M, Beekman AT, Kluiter H, Ribbe MW: Diagnostic accuracy of the original 30-item and shortened versions of the Geriatric Depression Scale in nursing home patients. Int J Geriatr Psychiatry 2005, 20(11):1067-1074.
    • 57. Sutcliffe C, Cordingley L, Burns A, Mozley CG, Bagley H, Huxley P, Challis D: A new version of the geriatric depression scale for nursing and residential home populations: the geriatric depression scale (residential) (GDS-12R). Int Psychogeriatr 2000, 12(2):173-181.
    • 58. Lin DY, Feuer EJ, Etzioni R, Wax Y: Estimating medical costs from incomplete follow-up data. Biometrics 1997, 53(2):419-434.
    • 59. Carides GW, Heyse JF, Iglewicz B: A regression-based method for estimating mean treatment cost in the presence of right-censoring. Biostatistics 2000, 1(3):299-313.
    • 60. Schulz KF, Altman DG, Moher D: CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMC Med 2010, 8:18.
    • 61. Twisk J, de Vente W: Attrition in longitudinal studies. How to deal with missing data. J Clin Epidemiol 2002, 55(4):329-337.
    • 62. Twisk JW, de Vente W: The analysis of randomised controlled trial data with more than one follow-up measurement. A comparison between different approaches. Eur J Epidemiol 2008, 23(10):655-660.
  • Inferred research data

    The results below are discovered through our pilot algorithms. Let us know how we are doing!

    Title Trust
  • No similar publications.