OBJECTIVE To evaluate the effects of early discharge followed by geriatric interdisciplinary home rehabilitation for older people with hip fracture on independence in Activities of Daily Living (ADLs) compared with in-hospital geriatric care according to a multifactorial rehabilitation program. DESIGN Pre-planned analysis of a randomized controlled trial with 3 and 12 month follow-ups. SETTING Geriatric ward, ordinary housing and residential care facilities. PARTICIPANTS Of 466 people screened for eligibility, 205 participants with acute hip fracture, aged 70 or older, including those with cognitive impairment, and those living in residential care facilities, were randomized to intervention or control groups. INTERVENTION Individually designed interdisciplinary home rehabilitation for a maximum of 10 weeks. The intervention aimed at early hospital discharge and focused on prevention of falls, independence in daily activities, and walking ability indoors and outdoors. MAIN OUTCOME MEASURES Independence in ADLs was measured using the Barthel ADL Index, and the ADL Staircase including the Katz ADL Index. during hospital stay (pre-fracture performance) and at the follow-ups in the participants' homes. RESULTS There were no significant differences in ADL performance between the groups, and they recovered their pre-fracture level of independence in personal and instrumental ADLs comparably. At 12 months, 33 (41.3%) in intervention group vs 33 (41.8%) in control group (p = 1.000) had regained or improved their pre-fracture ADL performance according to the Barthel ADL Index, and 27 (37.0%) vs 36 (48.6%) according to the ADL Staircase (p = 0.207). CONCLUSIONS In older people with hip fracture, early discharge followed by geriatric interdisciplinary home rehabilitation resulted in comparable recovery of independence in ADLs at 3 and 12 months as in-hospital geriatric care and rehabilitation.

中文翻译：

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老年跨学科家庭康复对髋部骨折老年人日常生活活动独立性的影响：一项随机对照试验。

目的 根据多因素康复计划，与院内老年护理相比，评估髋部骨折老年人早期出院后进行老年跨学科家庭康复对日常生活活动 (ADL) 独立性的影响。设计 一项随机对照试验的预先计划分析，随访 3 个月和 12 个月。设置老年病房、普通住房和住宿护理设施。参与者 在接受资格筛选的 466 人中，205 名患有急性髋部骨折、年龄在 70 岁或以上的参与者（包括认知障碍者和居住在养老院的参与者）被随机分配到干预组或对照组。干预 个性化设计的跨学科家庭康复，最长 10 周。该干预旨在早期出院，重点是预防跌倒、日常活动的独立性以及室内和室外的步行能力。主要观察指标 使用 Barthel ADL 指数和包括 Katz ADL 指数的 ADL 阶梯测量 ADL 的独立性。在住院期间（骨折前表现）和参与者家中的随访。结果 各组之间的 ADL 表现没有显着差异，并且他们在个人和工具 ADL 中恢复了骨折前的独立性水平。在 12 个月时，根据 Barthel ADL 指数，干预组 33 (41.3%) 与对照组 (p = 1.000) 的 33 (41.8%) 恢复或改善了骨折前的 ADL 表现，27 (37.0%) 与36 (48.6%) 根据 ADL 楼梯 (p = 0.207)。