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
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.
KeywordsHip 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).
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