The effects of strength training on muscle strength, asymmetry in lower limb muscle strength and mobility in older men and women with a history of hip fracture

ISRCTN	ISRCTN34271567
DOI	https://doi.org/10.1186/ISRCTN34271567
Protocol serial number	N/A
Sponsor	Ministry of Education Finland
Funders	Ministry of Education (Finland), Finnish Cultural Foundation (Finland), Juho Vainio Foundation (Finland)

Submission date: 01/06/2006
Registration date: 13/07/2006
Last edited: 06/02/2013

Recruitment status: No longer recruiting
Overall study status: Completed
Condition category: Musculoskeletal Diseases

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Ms Erja Portegijs
Scientific

Finnish Centre for Interdisciplinary Gerontology
Department of Health Sciences
University of Jyväskylä
P.O. Box 35 (viv)
Jyväskylä
FI-40014
Finland

Email	erja.portegijs@sport.jyu.fi

Study information

Primary study design	Interventional
Study design	A randomised controlled trial; men and women randomised in blocks. Data collected in two phases using the exact same protocol equipment and staff.
Secondary study design	Randomised controlled trial
Scientific title
Study objectives	Older people with a history of hip fracture often have generally low muscle strength and power in the lower limbs, especially on the fractured side, which may result in mobility limitations. This considerable asymmetrical deficit may further complicate balance and independent living. Progressive strength-power training may increase muscle strength and power. Taking into account asymmetrical deficit in the lower limbs may lead to larger improvements in mobility function in older people than conventional strength training.
Ethics approval(s)	The study was approved by the Ethical Committee of the Jyväskylä Central Hospital Board on 14/10/2004
Health condition(s) or problem(s) studied	Hip fracture
Intervention	Participants assigned to the intervention groups, participated twice a week in a 12-week progressive strength-power training specifically designed to increase lower limb muscle strength and power and to reduce asymmetry in lower limb strength and power. Resistance equipment was used to train: leg press, knee flexion, hip abduction and adduction exercises, in addition, plantar flexion exercise was provided by means of a weighted vest. The one repetition maximum (1 RM; calculated from the observed 3-5 RM) for the exercises used in the training was assessed twice during the training. The resistance of the strength training (usual velocity) was progressively increased from 50 to 80 % of the 1RM of the respective leg. Leg press and plantar flexion exercises were trained in addition with high-velocity low-load resistance (power training). For these exercises, the number of repetitions was progressively increased. In order to equalise muscle strength and power asymmetry between the legs, the weaker leg was trained with more sets of repetitions and/or a higher percentage of resistance. The training was supervised by an experienced physiotherapist. The participants assigned to the control group were encouraged to continue their lives as they were used to.
Intervention type	Other
Primary outcome measure(s)	1. Maximal muscle strength and power in both legs: 1.1. Voluntary isometric knee extension strength 1.2. Rate of force production 1.3. Leg extension power (Nottingham power-rig) 2. The strength and power difference between the legs (asymmetry) 3. Mobility (habitual and maximal walking velocity and other walking parameters, such as step length and time 4. Time of walking a figure 8 5. Ability and time to climb stairs 6. Timed-up-go test 7. Chair rise ability and time
Key secondary outcome measure(s)	1. Balance: 1.1. Static and dynamic balance measured on a force plate 1.2. Functional balance (Berg balance scale) 1.3. Self-assessed balance confidence (ABC scale) 2. Falls (collected retrospectively and by means of a prospective follow-up) 3. Disability 4. Pain in the legs 5. Bone density and geometry of tibia (peripheral computed tomography)
Completion date	31/12/2006

Eligibility

Participant type(s)	Patient
Age group	Senior
Sex	All
Target sample size at registration	60
Key inclusion criteria	Community-dwelling 60 - 85-year-old men and women living in the Jyvaskyla Central Hospital District that had an operation following a hip fracture, from six months to seven years earlier
Key exclusion criteria	The criteria of American College of Sports Medicine (e.g. severe cardiovascular disease) were used to exclude people from participation in the randomized controlled trial. Additionally, severe progressive (e.g. cancer) or neurological disease (e.g. advanced Alzheimer's disease), lower limb amputation, inability to walk outside without assistance of another person and alcohol abuse were used as exclusion criteria for this study.
Date of first enrolment	01/06/2004
Date of final enrolment	31/12/2006

Locations

Countries of recruitment

Finland

Study participating centre

Finnish Centre for Interdisciplinary Gerontology

Jyväskylä
FI-40014
Finland

Results and Publications

Individual participant data (IPD) Intention to share	No
IPD sharing plan summary	Not provided at time of registration
IPD sharing plan

Study outputs

Output type	Details	Date created	Date added	Peer reviewed?	Patient-facing?
Results article	results	01/09/2008		Yes	No
Results article	results	01/12/2012		Yes	No
Study website	Study website	11/11/2025	11/11/2025	No	Yes