02067nas a2200193   4500000000100000008004100001100002600042700001900068700001700087700001200104700001500116700001500131245009700146250001500243300001100258490000700269520155100276020004601827       2010                            d1 aSherrington Catherine1 aNightingale E.1 aSturnieks D.1 aLord S.1 aCameron I.1 aMoseley A.00aImpaired weight transfer persists at least four months after hip fracture and rehabilitation  a2010/04/23  a565-730 v243 a<p>
OBJECTIVE: To determine whether choice stepping reaction time performance is impaired in people after hip fracture and whether different aspects of choice stepping performance improve with rehabilitation. DESIGN: This study includes a secondary analysis of data obtained from participants in a randomized controlled trial of exercise after hip fracture. SETTING: Data were either collected in a hospital rehabilitation unit, research institute or participant homes. SUBJECTS: The hip fracture group (n = 91) were recruited from three rehabilitation hospitals in metropolitan Sydney. The control group (n = 77) were healthy age-, gender- and dwelling-matched controls, participating in unrelated studies of fall risk factors. MAIN MEASURES: Response time, movement time and total time components of the choice stepping reaction time test. RESULTS: Improvements in choice stepping reaction time were seen in people after hip fracture, during a 16-week rehabilitation period, however performance remained impaired (1808 +/- 663 ms), compared with matched controls (1029 +/- 255 ms, P&lt;0.001). Further, choice stepping performance was significantly slower when transferring weight onto the affected leg (1271 +/- 615 ms), compared with the unaffected leg (1119 +/- 499 ms, P&lt;0.001). CONCLUSIONS: Movement deficits are evident for an extended time frame following rehabilitation for hip fracture. The slower response time following the rehabilitation period highlights ongoing difficulties with weight transfer onto the affected leg.
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