Allied health assistants can provide acute post-operative rehabilitation for people with hip fracture: a feasibility randomised controlled trial

Allied health assistants can provide acute post-operative rehabilitation for people with hip fracture: a feasibility randomised controlled trial

David Snowdon^1,2, Peggy Vincent¹, Michele Callisaya^1,2, Taya Collyer², Natasha Brusco², Yi Tian Wang¹, Nicholas Taylor<sup>3,4

1</sup>Peninsula Health, Frankston , Victoria, Australia
²Monash University, Frankston, Victoria, Australia
³La Trobe University, Melbourne, Victoria, Australia
⁴Eastern Health, Box Hill, Victoria, Australia

Abstract

Background:
Allied health assistants (AHAs) support physiotherapists with the provision of exercise and mobility programs. However, AHAs are under utilised in the provision of patient care in acute hospitals. This feasibility randomised controlled trial aimed to determine whether it is safe and feasible to delegate post-operative hip fracture rehabilitation to AHAs under the supervision of a physiotherapist.

Method:
Participants were recruited post hip fracture surgery and randomised to receive acute rehabilitation either from a physiotherapist or an AHA under supervision of a physiotherapist. Feasibility and length of stay outcomes were analysed using descriptive statistics and t-tests, with feasibility determined according to Bowen’s framework focus areas (demand, acceptability, practicality and implementation). Cox proportional hazards regression was used for guideline adherence.

Results:
Fifty post operative hip fracture surgery inpatients were randomised to either physiotherapy (n=25) or AHA (n=25). There is demand, with 49% of eligible participants recruited. Acceptability and practicality were established with comparable patient satisfaction surveys between groups, and no differences in adverse events between groups. Implementation was successful; the AHA group received 11 minutes more therapy per day (95%CI 4 to 19). The AHA group were also 20% (95%CI 1% to 28%) more likely to meet mobilisation guidelines and may have had a shorter length of stay (MD: -0.8 days, 95%CI: -2.3 to 0.7).

Discussion:
AHA rehabilitation for post-operative hip fracture inpatients is feasible and may reduce length of stay and improve compliance with hip fracture mobilisation guidelines.

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