Evidence map›Paper›PMID 33823028›Full record

Trial reportPhysical therapy2021

Using Treatment Fidelity Measures to Understand Walking Recovery: A Secondary Analysis From the Community Ambulation Project.

Kathleen K Mangione, Michael A Posner, Rebecca L Craik, Edward F Wolff, Richard H Fortinsky, Brock A Beamer, Ellen F Binder, Denise L Orwig, Jay Magaziner, Barbara Resnick

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Physical therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Kathleen K MangioneDepartment of Physical Therapy, Arcadia University, 450 S Easton Rd, Glenside, Pennsylvania, USA.
Michael A PosnerDepartment of Mathematics and Statistics, Villanova University, Villanova, Pennsylvania, USA.
Rebecca L CraikCollege of Health Science, Department of Physical Therapy, Arcadia University, Glenside, Pennsylvania, USA.
Edward F WolffDepartment of Computer Science and Mathematics, Arcadia University, Glenside, Pennsylvania, USA.
Richard H FortinskyUConn Center on Aging, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
Brock A BeamerDepartment of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Ellen F BinderDivision of Geriatrics and Nutritional Science, Washington University School of Medicine in St Louis, St Louis, Missouri, USA.
Denise L OrwigDepartment of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Jay MagazinerSchool of Medicine, University of Maryland, Baltimore, Maryland, USA.
Barbara ResnickSchool of Nursing, University of Maryland, Baltimore, Maryland, USA.

Funding

University of Maryland Claude D. Pepper Older Americans Independence Center (UM-OAIC)P30AG028747 · NIA · UNIVERSITY OF MARYLAND BALTIMORE · PI ALICE S. RYAN · 2006 to 2026
$28.9M
Sequelae of Hip Fracture in Men: An Epidemiologic StudyR37AG009901 · NIA · UNIVERSITY OF MARYLAND BALTIMORE · PI MAGAZINER, JAY · 1992 to 2018
$11.3M
Community Ambulation Following Hip FractureR01AG035009 · NIA · UNIVERSITY OF MARYLAND BALTIMORE · PI MAGAZINER, JAY · 2010 to 2016
$11.0M
RESEARCH TRAINING IN THE EPIDEMIOLOGY OF AGINGT32AG000262 · NIA · UNIVERSITY OF MARYLAND BALTIMORE · PI ANN L GRUBER-BALDINI, DENISE L ORWIG · 1998 to 2026
$8.2M
The Epidemiology of Bone Strength and Muscle Composition After Hip Fracture in MeR01AG029315 · NIA · UNIVERSITY OF MARYLAND BALTIMORE · PI MAGAZINER, JAY · 2007 to 2011
$4.1M
Timing And Intensity Of Strengthening After Hip FractureR21HD043269 · NICHD · ARCADIA UNIVERSITY · PI CRAIK, REBECCA LYNN · 2002 to 2003
$316k
NIA NIH HHS P30 AG028747NIA NIH HHS R01 AG029315NIA NIH HHS R01 AG035009NIA NIH HHS R37 AG009901NIA NIH HHS T32 AG000262NICHD NIH HHS R21 HD043269
6 · The paper itself

Abstract

objectivesPhysical therapist intervention studies can be deemed ineffective when, in fact, they may not have been delivered as intended. Measurement of treatment fidelity (TF) can address this issue. The purpose of this study was to describe TF of a home-based intervention, identify factors associated with TF, and examine whether components of TF were associated with the outcome of change in 6-minute walk distance (∆6MWD).

methodsThis is a secondary analysis of community-dwelling hip fracture participants who completed standard therapy and were randomly assigned to the active intervention (Push). Push was 16 weeks of lower extremity strengthening, function, and endurance training. TF was defined as delivery (attendance rate, exercise duration) and receipt (progression in training load, heart rate reserve [HRR] during endurance training, and exercise position [exercise on floor]). The outcome was ∆6MWD. Independent variables included baseline (demographic and clinical) measures. Descriptive statistics were calculated; linear and logistic regressions were performed.

resultsEighty-nine participants were included in this analysis; 59 (66%) had attendance of 75% or greater. Participants walked for 20 minutes or more for 78% of sessions. The average training load increased by 22%; the mean HRR was 35%; and 61 (69%) participants exercised on the floor for at least 75% of sessions. Regression analyses showed that a higher body mass index and greater baseline 6MWD were related to components of TF; 4 out of 5 components of TF were significantly related to ∆6MWD. The strongest TF relationship showed that those who exercised on the floor improved by 62 m (95% CI = 31-93 m) more than those who did not get on the floor.

conclusionsMeasures of TF should extend beyond attendance rate. This analysis demonstrates how measures of TF, including program attendance, progression in training load, endurance duration, and exercising on the floor were significantly related to improvement in 6MWD in participants post hip fracture. IMPACT: This careful analysis of treatment fidelity assured that the intervention was delivered and received as intended. Analysis of data from a large trial with participants after hip fracture showed that regular attendance, frequent endurance training for 20 minutes, increases in lower extremity training loads, and exercising on the floor were associated with improvements in the outcome of 6-minute-walk distance. The strongest association with improvement was exercising on the floor.

Indexed as

Patient ComplianceWalkingAgedAged, 80 and overExercise TherapyFemaleHip FracturesHumansMaleWalk TestExerciseHip FracturesPhysical TherapistsTreatment Fidelity

Identifiers

PMID33823028
PMCPMC8520021

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.