Progression and adherence to an individually prescribed and supervised resistance training intervention in older adults recovering in hospital from lower limb fragility fracture

Michelle D Miller¹, Amanda Foley², Simon M Gunn², Maria Crotty²

¹Department of Nutrition and Dietetics, ²Department of Rehabilitation and Aged Care, Flinders University, Adelaide, Australia

Abstract: This study evaluated adherence and progression with a 12-week resistance training program amongst a sample of older adults recovering in hospital from lower limb fragility fracture. Forty-nine participants (mean age 84 years) commenced the resistance training program seven days after the injury. The exercise prescription involved training of the hip and knee extensors, hip abductors, and ankle plantar- and dorsi flexors using resistive bands. Exercise sessions were completed tri-weekly for six weeks under supervision by a physiotherapist and tri-weekly for an additional six weeks independently. Adherence was assessed as the proportion of exercise sessions completed of those prescribed and any progression in resistance was documented. Level of adherence was not found to be influenced by age, gender, cognition or strength but was greater amongst those admitted from the community setting and for the first six weeks when supervision was present. Participants were able to obtain similar levels of resistance for the injured side compared to the noninjured side for all exercises excluding hip abduction and those admitted from the community setting achieved higher levels of resistance compared to those admitted from the residential care setting. These findings suggest that an early resistance training program is feasible and well tolerated amongst older adults recovering from lower limb fragility fracture. Further work is necessary to determine how this level of resistance training translates into functional improvements and how to improve adherence levels in clinical rehabilitation settings.

Keywords: aged, rehabilitation, exercise, adherence, hip fracture