Tsauo 2005.
Study characteristics | ||
Methods | Randomised: method not specified | |
Participants | People recently discharged from an acute orthopaedic unit, National Taiwan University Hospital, Taiwan Period of study: October 2000 to September 2001 54 participants Inclusion: people recently discharged from hospital after surgery for a hip fracture; agreement to participate from participant and surgeon; written informed consent Exclusion: individual or family rejected further treatment or follow‐up; did not have transport or were not in hospital neighbourhood; were unable to co‐operate due to cognitive problems; or had ongoing medical litigation Age (of 25 completers): mean 73 years (range not given) % male (of 25 completers): 20 Number lost to follow‐up: 29 (25 lost and 4 excluded due to low compliance) | |
Interventions | Commenced after hospital discharge (mean 11 days)
1. Home‐based individualised physical therapy programme delivered in 8 visits over 3 months and involving strengthening exercises, range‐of‐motion exercises, balance training, functional training (such as sit‐to‐stand, ambulation and stair‐climbing training), practice of transfer techniques, adjustment of walking aids and adaptation and modification of the home environment. 5 exercises were taught at each visit, initially in 3 sets of 10 repetitions a day for each item, progressed at the visits.
versus
2. Practice of an exercise programme given at the bedside before discharge All participants had bedside physiotherapy during their hospital stay. |
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Outcomes | Length of follow‐up: 6 months Strength Harris Hip Score Walking speed Quality of life: assessed 4 domains of the WHOQOL‐BREF (physical health, psychosocial, social relationship, environment) Adverse events: wound infection |
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Notes | Article notes that most people in Taiwan do not receive physiotherapy after they leave hospital because there is no insurance payout for such services. Funding: supported by the National Science Council (grant nos. NSC‐89‐2320‐B‐002‐051‐ M5, NSC‐90‐2320‐B‐002‐012‐M56). Conflict of interest: none |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | "Patients were randomized". The method of randomisation was not described. |
Allocation concealment (selection bias) | Unclear risk | "Patients were randomized". No methods for concealing allocation were described. |
Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Therapists conducting the intervention and participants were not blinded to the group assignment. Impact of non‐blinding is unclear |
Blinding of outcome assessment (detection bias) Observer‐reported outcomes, some judgement | High risk | No blinding was reported. |
Blinding of outcome assessment (detection bias) Observer‐reported outcomes, no judgement | Unclear risk | No blinding was reported; unknown risk of bias. |
Blinding of outcome assessment (detection bias) Participant/proxy‐reported outcomes | High risk | No blinding was reported. |
Incomplete outcome data (attrition bias) Observer‐reported outcomes, some judgement | High risk | Baseline 3‐month and 6‐month follow‐up data were only available for 25 of the 54 trial participants and an intention‐to‐treat analysis was not carried out. 4 poor compliers with the intervention were excluded. |
Incomplete outcome data (attrition bias) Death, re‐admission, re‐operation, surgical complications, return to living at home | High risk | Baseline 3‐month and 6‐month follow‐up data were only available for 25 of the 54 trial participants and an intention‐to‐treat analysis was not carried out. 4 poor compliers with the intervention were excluded. |
Incomplete outcome data (attrition bias) Participant/proxy‐reported outcomes | High risk | Baseline 3‐month and 6‐month follow‐up data were only available for 25 of the 54 trial participants and an intention‐to‐treat analysis was not carried out. 4 poor compliers with the intervention were excluded. |
Selective reporting (reporting bias) | Unclear risk | The outcomes recorded appeared to be reported. |
Free from baseline imbalance bias? | Unclear risk | Baseline data were only available for 25 of the 54 trial participants. For these 25 participants, only diabetes differed significantly between the 2 groups. The authors reported that the number and characteristics of the 25 participants (4 others were excluded for low compliance) lost to follow‐up were similar between the two groups. |
Free from performance bias due to non‐trial interventions? | Low risk | There appeared to be care programme comparability before discharge and identical follow‐up assessment procedures. |