A randomised trial of weight-bearing versus non-weight-bearing exercise for improving physical ability in inpatients after hip fracture

The purpose of this study was to assess the effects of weight-bearing and non-weight-bearing exercise on strength, balance, gait and functional performance among older inpatients following hip fracture. Eighty people (mean age 81 years, SD 8) undergoing inpatient rehabilitation after fall-related hip fracture were randomised to receive two-week programs of either weight-bearing or non-weight-bearing exercise prescribed by a physiotherapist. Both groups improved markedly (in the order of 50%) on measures of physical ability. Overall there was little difference between groups in the extent of improvement, however post hoc testing identified some additional strength benefits for the non-weight-bearing group - non-affected leg hip flexion mean difference in extent of improvement was 9.3 N (95% Cl 3.7 to 15.0), non-affected leg hip abduction mean difference in extent of improvement was 6.5 N (95% Cl 0.1 to 12.9). There were also additional functional benefits for the weight-bearing group - improved ability to complete a lateral step-up on the affected leg with nil or one hand supports (OR 3.4, 95% C1 1.1 to 12.3) and the need for less supportive walking aids (p = 0.045). Weight-bearing and non-weight-bearing exercise programs produce similar effects on strength, balance, gait and functional performance among inpatients soon after hip fracture.