Is a telerehabilitation programme for older adults with hip fracture associated with burden of family caregivers who provide support?

Objective @ctivehip is a home-based multidisciplinary telerehabilitation programme for older adults with hip fracture, conducted with the assistance of their family caregivers. This programme was useful in improving their functional recovery. Nevertheless, we were concerned about how the programme might have affected caregivers, whose assistance was essential for supporting older adults in using new technologies and ensuring their safety during the exercises and activities at home. The aim of the present study was to compare the burden, psychological factors and physical fitness of the family caregivers of older adults who opted the @ctivehip telerehabilitation programme versus those family caregivers of older adults who received the face-to-face rehabilitation provided by the Andalusian Public Healthcare System (in Spain). Methods In this single-blinded, non-randomized clinical trial, participants were older adults with hip fracture and their family caregivers. The telerehabilitation group (n = 30) underwent a 12-week multidisciplinary telerehabilitation programme, and the comparative group (n = 32) received face-to-face rehabilitation. Caregivers outcomes measured were (i) the burden using the Zarit Burden Interview, (ii) the anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), and (iii) the Physical Fitness with the International Fitness Scale (IFIS). Results There were not statistically significant differences on caregiver burden between family caregivers in the @ctivehip and the comparative group, although there was a trend towards lower values [[Mean (95%CI); 14.73 (9.09 to 20.37) vs 16.03 (10.63 to 21.43); p = 0.771] as well as for anxiety and depression [5.66 (3.21 to 8.78) vs 11.19 (8.52 to 13.86); p = 0.022]. Likewise achieved better, though not statistically significant, scores in physical fitness [19.37 (17.94 to 20.81) vs 17.15 (15.77 to 18.53); p = 0.055]. Conclusion Caregiver burden is not associated with telerehabilitation. In addition, telerehabilitation is associated with lower anxiety and depression levels among family caregivers who opt for this programme. Physical fitness is not related with telerehabilitation.

[1]  M. Ashe,et al.  Family Caregivers’ Experiences with Tele-Rehabilitation for Older Adults with Hip Fracture , 2021, Journal of clinical medicine.

[2]  V. Gallistl,et al.  Doing digital exclusion - technology practices of older internet non-users. , 2021, Journal of aging studies.

[3]  A. Tiedemann,et al.  Mobilisation and physiotherapy intervention following hip fracture: snapshot survey across six countries from the Fragility Fracture Network Physiotherapy Group , 2021, Disability and rehabilitation.

[4]  M. Martín-Matillas,et al.  Effects of the @ctivehip telerehabilitation program on the quality of life, psychological factors and fitness level of patients with hip fracture , 2021, Journal of telemedicine and telecare.

[5]  J. Kanis,et al.  SCOPE 2021: a new scorecard for osteoporosis in Europe , 2021, Archives of Osteoporosis.

[6]  Jersey Liang,et al.  A family care model for older persons with hip-fracture and cognitive impairment: A randomized controlled trial. , 2021, International journal of nursing studies.

[7]  M. Ashe,et al.  Effects of Tele-Rehabilitation Compared with Home-Based in-Person Rehabilitation for Older Adult’s Function after Hip Fracture , 2021, International journal of environmental research and public health.

[8]  P. Stolee,et al.  Transitional Care Experiences of Patients with Hip Fracture Across Different Health Care Settings , 2021, International journal of integrated care.

[9]  Amanda C. Everall,et al.  A qualitative study exploring the lived experiences of deconditioning in hospital in Ontario, Canada , 2021, BMC Geriatrics.

[10]  K. Willett,et al.  Patient and informal carer experience of hip fracture: a qualitative study using interviews and observation in acute orthopaedic trauma , 2021, BMJ Open.

[11]  M. Ashe,et al.  The Journey of Recovery: Caregivers’ Perspectives From a Hip Fracture Telerehabilitation Clinical Trial , 2020, Physical Therapy.

[12]  Amanda C. Everall,et al.  Patient and caregiver experiences on care transitions for adults with a hip fracture: a scoping review , 2020, Disability and rehabilitation.

[13]  I. Freytes,et al.  Feasibility and acceptability of a telephone and web-based stroke caregiver intervention: a pilot randomized controlled trial of the RESCUE intervention , 2020, Clinical rehabilitation.

[14]  Yongchun Zhou,et al.  Factors associated with the burden of family caregivers of elderly patients with femoral neck fracture: a cross-sectional study , 2020, Journal of Orthopaedic Surgery and Research.

[15]  F. López-Espuela,et al.  Quality of life in elderly people after a hip fracture: a prospective study , 2020, Health and Quality of Life Outcomes.

[16]  L. Low,et al.  Predictors of poor functional outcomes and mortality in patients with hip fracture: a systematic review , 2019, BMC Musculoskeletal Disorders.

[17]  Charlene H. Chu,et al.  Factors That Influence the Reintegration to Normal Living for Older Adults 2 Years Post Hip Fracture , 2019, Journal of applied gerontology : the official journal of the Southern Gerontological Society.

[18]  M. Ashe,et al.  Development and Evaluation of a Post–Hip Fracture Instructional Workshop for Caregivers , 2019, Journal of geriatric physical therapy.

[19]  J. Jiménez-Moleón,et al.  High perceived caregiver burden for relatives of patients following hip fracture surgery , 2019, Disability and rehabilitation.

[20]  M. Arroyo-Morales,et al.  A home‐based tele‐rehabilitation protocol for patients with hip fracture called @ctivehip , 2018, Research in nursing & health.

[21]  M. Perracini,et al.  Physiotherapy following fragility fractures. , 2018, Injury.

[22]  N. Veronese,et al.  Epidemiology and social costs of hip fracture. , 2018, Injury.

[23]  M. Kalu,et al.  The Burden Experience of Formal and Informal Caregivers of Older Adults With Hip Fracture in Nigeria , 2018, SAGE open nursing.

[24]  T. Gosens,et al.  Care-related Quality of Life of informal caregivers of the elderly after a hip fracture , 2018, Journal of Patient-Reported Outcomes.

[25]  Clemens Becker,et al.  Epidemiology of hip fractures , 2018, Zeitschrift für Gerontologie und Geriatrie.

[26]  E. Tutton,et al.  Understanding informal carers’ experiences of caring for older people with a hip fracture: a systematic review of qualitative studies , 2018, Disability and rehabilitation.

[27]  Konstantinos N Malizos,et al.  Quality of life and psychological consequences in elderly patients after a hip fracture: a review , 2018, Clinical interventions in aging.

[28]  Francisco Javier Barón-López,et al.  Evidence of Benefit of Telerehabitation After Orthopedic Surgery: A Systematic Review , 2017, Journal of medical Internet research.

[29]  F. Grodstein,et al.  Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project , 2017, Journal of internal medicine.

[30]  M. Hernán,et al.  ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions , 2016, British Medical Journal.

[31]  A. Soriano‐Maldonado,et al.  International FItness Scale (IFIS): Construct Validity and Reliability in Women With Fibromyalgia: The al-Ándalus Project. , 2016, Archives of physical medicine and rehabilitation.

[32]  M. Crotty,et al.  ‘Well, if the kids can do it, I can do it’: older rehabilitation patients' experiences of telerehabilitation , 2016, Health expectations : an international journal of public participation in health care and health policy.

[33]  L. Fleig,et al.  Back to the future – feasibility of recruitment and retention to patient education and telephone follow-up after hip fracture: a pilot randomized controlled trial , 2015, Patient preference and adherence.

[34]  Chi-Chuan Wu,et al.  Family caregivers' mental health is associated with postoperative recovery of elderly patients with hip fracture: a sample in Taiwan. , 2015, Journal of psychosomatic research.

[35]  T. Rantanen,et al.  Effects of a multicomponent home-based physical rehabilitation program on mobility recovery after hip fracture: a randomized controlled trial. , 2014, Journal of the American Medical Directors Association.

[36]  V. Martínez-Vizcaíno,et al.  Self‐reported and measured cardiorespiratory fitness similarly predict cardiovascular disease risk in young adults , 2013, Scandinavian journal of medicine & science in sports.

[37]  J. Guralnik,et al.  Validity and reliability of the Short Physical Performance Battery (SPPB) , 2013, Colombia medica.

[38]  P. Brennan,et al.  A Theory-Based Online Hip Fracture Resource Center for Caregivers: Effects on Dyads , 2012, Nursing research.

[39]  Jersey Liang,et al.  Trends in health outcomes for family caregivers of hip-fractured elders during the first 12 months after discharge. , 2012, Journal of advanced nursing.

[40]  R. Sterling.  Gender and Race/Ethnicity Differences in Hip Fracture Incidence, Morbidity, Mortality, and Function , 2011, Clinical orthopaedics and related research.

[41]  T. Howe,et al.  Stress levels amongst caregivers of patients with osteoporotic hip fractures - a prospective cohort study. , 2010, Annals of the Academy of Medicine, Singapore.

[42]  N. O’Rourke,et al.  Reliability generalization of responses by care providers to the Zarit Burden Interview , 2007, Aging & mental health.

[43]  P. Lin,et al.  Psychosocial Factors Affecting Hip Fracture Elder's Burden of Care in Taiwan , 2007, Orthopedic nursing.

[44]  T. T. Haug,et al.  The validity of the Hospital Anxiety and Depression Scale. An updated literature review. , 2002, Journal of psychosomatic research.

[45]  D. Mclellan,et al.  Evidence-based measurement: Which disability scale for neurologic rehabilitation? , 2001 .

[46]  L. Ferrucci,et al.  A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. , 1994, Journal of gerontology.

[47]  S. Zarit,et al.  Relatives of the impaired elderly: correlates of feelings of burden. , 1980, The Gerontologist.

[48]  S. Folstein,et al.  “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician , 1975 .

[49]  P. Stergiannis,et al.  The Burden of Caregivers of Patients After Hip Replacement and Its Impact on the Cost of Living of the Family. , 2021, Advances in experimental medicine and biology.

[50]  R. Momosaki,et al.  Characteristics of rehabilitation services in high-FIM efficiency hospitals after hip fracture. , 2019, The journal of medical investigation : JMI.

[51]  G. J. C. Pereira,et al.  Informal caregivers of older people recovering from surgery for hip fractures caused by a fall: fall prevention. , 2015, Ciencia & saude coletiva.