Effectiveness of a Home-Based Fragility Fracture Integrated Rehabilitation Management (FIRM) Program in Patients Surgically Treated for Hip Fractures

Background: The purpose of this study was to investigate the effectiveness of a home-based fragility fracture integrated rehabilitation management (H-FIRM) program following an inpatient FIRM (I-FIRM) program in patients surgically treated for hip fracture. Methods: This nonrandomized controlled trial included 32 patients who underwent hip surgery for a fragility hip fracture. The patients were divided into two groups: a prospective intervention group (n = 16) and a historical control group (n = 16). The intervention group performed a nine-week H-FIRM program combined with the I-FIRM program. The historical control group performed the I-FIRM program only. Functional outcomes included Koval&rsquo
s grade, Functional Ambulatory Category (FAC), Functional Independence Measure (FIM) locomotion, Modified Rivermead Mobility Index (MRMI), 4 m walking speed test (4MWT), and the Korean version of Modified Barthel Index (K-MBI). All functional outcomes were assessed one week (before I-FIRM), three weeks (before I-FIRM), and three months (after H-FIRM) after surgery. Results: Both groups showed significant and clinically meaningful improvements in functional outcomes over time. Compared with the control group, the intervention group showed clinically meaningful improvements in Koval&rsquo
s grade, FAC, FIM locomotion, MRMI, 4MWT, and K-MBI from baseline to three months. Conclusion: H-FIRM may be an effective intervention for improving functional outcomes in older people after fragility hip fractures.