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. 2025 Jan 7:8982643241311624.
doi: 10.1177/08982643241311624. Online ahead of print.

Impact of a Multi-Component Home-Based Physical Therapy Intervention on Cognitive Outcomes: Results From the CAP Randomized Controlled Trial

Ann L Gruber-Baldini  1 , Richard H Fortinsky  2 , Barbara Resnick  3 , Laurence S Magder  1 , Brock A Beamer  4   5 , Kathleen Mangione  6 , Denise Orwig  1 , Ellen F Binder  7 , Michael Terrin  1 , Jay Magaziner  1
Affiliations

Impact of a Multi-Component Home-Based Physical Therapy Intervention on Cognitive Outcomes: Results From the CAP Randomized Controlled Trial

Ann L Gruber-Baldini et al. J Aging Health. .

Abstract

Objective: Differences in cognitive outcomes for two home-based 16-week interventions after usual rehabilitative care post-hip fracture were examined.

Methods: Community Ambulation Project randomized controlled trial included 210 hip fracture participants. Interventions: Specific multi-component (PUSH) included strength-, balance-, function-, and endurance-based exercises; non-specific active control (PULSE) included seated range-of-motion exercises and sensory transcutaneous electrical neurostimulation. Cognitive measures: Modified Mini-Mental State Examination, plus Hooper Visual Organization Test and Trails A/B in an ancillary study (CAP-MP, n = 40), assessed pre-randomization and 16 and 40 weeks post-randomization.

Results: Over 16 weeks, PUSH-assigned participants became faster on Trails A (Δ = -6.3, 95% CI: -16.7, 4.2); those in PULSE became slower (Δ = 9.3, 95% CI: -1.7, 20.3, p = .04). At 40 weeks, PUSH-assigned participants became faster on Trails B (Δ = -21.5, 95% CI: -46.2, 3.3) while those in PULSE became slower (Δ = 15.2, 95% CI: -11.9, 42.3, p = .04). No other significant differences were found.

Discussion: Results suggest that multi-component exercise interventions like PUSH may prevent/delay decline or improve attention and psychomotor speed in patients with recent hip fracture.

Keywords: RCT; cognition; exercise; hip fracture.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1:
Figure 1:
Enrollment, Randomization, and Follow-up of Participants into the Community Ambulation Project (CAP), the CAP Baltimore Site, and the CAP mechanistic pathways (CAP-MP) project
Figure 2:
Figure 2:
Cognitive outcomes by treatment and time (estimated means and 95% CI from a repeated measures regression model) a: Modified Mini Mental Status b: Trails A c: Trails B d: Hooper Visual Organization Test
Figure 2:
Figure 2:
Cognitive outcomes by treatment and time (estimated means and 95% CI from a repeated measures regression model) a: Modified Mini Mental Status b: Trails A c: Trails B d: Hooper Visual Organization Test
Figure 2:
Figure 2:
Cognitive outcomes by treatment and time (estimated means and 95% CI from a repeated measures regression model) a: Modified Mini Mental Status b: Trails A c: Trails B d: Hooper Visual Organization Test
Figure 2:
Figure 2:
Cognitive outcomes by treatment and time (estimated means and 95% CI from a repeated measures regression model) a: Modified Mini Mental Status b: Trails A c: Trails B d: Hooper Visual Organization Test
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