Everyday Life After a Hip Fracture: What Community-Living
Older Adults Perceive as Most Beneficial for Their Recovery
SUPPLEMENTARY DATAAppendix 1 The SO-HIP trial
From April 1, 2016 to December 1, 2017, we conducted the SO-HIP three-arm, stepped-wedge, cluster-randomized trial in six skilled nursing facilities (SNFs), (12 wards). The participants of the SO-HIP trial (240) were older adults who recovered after a hip fracture. The study, aimed to compare the effects a transitional care rehabilitation program in which sensor technology was used in coaching on daily functioning of older adults after hip fracture to occupational therapy without sensor technology and to usual care.
Three pairs of SNFs were randomized to one of three fixed sequences. Each sequence started with providing care as usual (the control condition) followed by cognitive behavioral therapy (CBT)-based occupational therapy and ending with CBT-(CBT)-based occupational therapy with sensor monitoring.
The primary outcome was patient-reported daily functioning at 6 months, assessed with the Canadian Occupational Performance Measure (COPM).
The intervention consisted of a coaching component and the use of sensor technology to support older adults in their recovery after hip fracture. The coaching was based on the principles of a CBT program concerning falls and focuses on setting realistic goals for increasing performance in meaningful daily functioning at home. The sensor technology consisted of a wearable sensor worn on the hip and a few ambient sensors at home and a web-based application, that were used to assist the older adults in obtaining feedback on their activities and as a tool to assist therapists in coaching. (See www.sohipstudie.nl)
The results of the trial are reported elsewhere. We concluded that among older patients after hip fracture, a rehabilitation intervention with coaching and sensor monitoring was more effective in improving patient-reported performance of daily functioning at six months than an intervention with coaching without sensor monitoring and usual care.
Figure A. Therapist and client looking together at the sensor data
Appendix 2 Example of interview questions
Initial questions were broad, e.g., “Since you have been back home, how have you been doing?” More focused questions were asked regarding specific topics, e.g., “What has changed in your daily living since you had a hip fracture?”, “Which aspects of the rehabilitation, or what recently, was most helpful for you in your ability to function at home again?” and “Do you think the sensor data could support or motivate you in optimizing your daily functioning?” An example of an ending question was “Of all that we discussed, what recently do you perceive as most beneficial in optimizing your daily functioning?”
