Quality of Life Research

, Volume 28, Issue 5, pp 1377–1386 | Cite as

Effects of a simple home exercise program and vitamin D supplementation on health-related quality of life after a hip fracture: a randomized controlled trial

  • K. Renerts
  • K. Fischer
  • B. Dawson-Hughes
  • E. J. Orav
  • G. Freystaetter
  • H.-P. Simmen
  • H.-C. Pape
  • A. Egli
  • R. Theiler
  • H. A. Bischoff-FerrariEmail author



To test the effects of vitamin D intervention and a simple home exercise program (HE) on health-related quality of life (HRQL) in the first 12 months after hip fracture.


HRQL was reported in 173 acute hip fracture patients (mean age 84 years, 79% females, 77% community dwelling) who were enrolled in the 12-month 2 × 2 factorial Zurich Hip Fracture Trial. Pre-fracture HRQL was assessed at baseline (4.2 ± 2.2 days post-surgery) and then again at 6 and 12 months after hip fracture surgery by the EuroQol EQ-5D-3L index value (EQ-5D-3L questionnaire). The effects of vitamin D intervention (2000 vs. 800 IU vitamin D3) and exercise (HE vs. no HE) or of the combined interventions on HRQL were assessed using multivariable-adjusted repeated-measures linear mixed-effects regression models.


The EQ-5D-3L index value significantly worsened from 0.71 pre-fracture to 0.57 over 12 months, but the degree of worsening did not differ between individual or combined interventions. However, regarding only the late recovery between 6 and 12 months, the group receiving neither intervention (800 IU/day and no HE) experienced a significant further decline in the EQ-5D-3L index value (adjusted mean change = 0.08 [95% CI 0.009, 0.15], p = 0.03) while all other groups remained stable.


Hip fractures have a long-lasting negative effect on HRQL up to 12 months after hip fracture. However, HE and/or 2000 IU vitamin D per day may help prevent a further decline in HRQL after the first 6 months following the acute hip fracture event.


Hip fracture Quality of life Exercise Vitamin D RCT Elderly 



This analysis was funded by the Baugarten Centre Grant for the Centre on Aging and Mobility (Dr. Bischoff-Ferrari), and by the University Research Priority Program “Dynamics of Healthy Aging” (Dr. Bischoff-Ferrari), University of Zurich. The original trial was supported by Swiss National Foundations (NFP-53) (Drs Bischoff-Ferrari and Theiler), Vontobel Foundation (Dr Bischoff-Ferrari), Baugarten Foundation (Dr Bischoff-Ferrari), and Swiss National Foundations professorship grant PP00B- 114864 (Dr Bischoff-Ferrari).

Supplementary material

11136_2019_2100_MOESM1_ESM.docx (66 kb)
Supplementary material 1 (DOCX 66 KB)


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • K. Renerts
    • 1
    • 2
    • 3
    • 6
  • K. Fischer
    • 1
    • 2
    • 6
  • B. Dawson-Hughes
    • 4
    • 6
  • E. J. Orav
    • 4
    • 6
  • G. Freystaetter
    • 1
    • 2
    • 3
    • 6
  • H.-P. Simmen
    • 3
    • 5
    • 6
  • H.-C. Pape
    • 3
    • 5
    • 6
  • A. Egli
    • 1
    • 2
    • 6
  • R. Theiler
    • 1
    • 2
    • 3
    • 6
  • H. A. Bischoff-Ferrari
    • 1
    • 2
    • 3
    • 6
    • 7
    Email author
  1. 1.Department of Geriatrics and Aging ResearchUniversity Hospital Zurich and University of ZurichZurichSwitzerland
  2. 2.Centre on Aging and MobilityUniversity Hospital Zurich and City Hospital WaidZurichSwitzerland
  3. 3.Centre for Senior Trauma CareUniversity Hospital ZurichZurichSwitzerland
  4. 4.Jean Mayer USDA Human Nutrition Research Center on AgingTufts UniversityBostonUSA
  5. 5.Department of BiostatisticsHarvard School of Public HealthBostonUSA
  6. 6.Department of TraumatologyUniversity Hospital ZurichZurichSwitzerland
  7. 7.University Clinic for Acute Geriatric Care, City Hospital WaidZurichSwitzerland

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