Effect of 800 IU Versus 2000 IU Vitamin D3 With or Without a Simple Home Exercise Program on Functional Recovery After Hip Fracture: A Randomized Controlled Trial
The Journal of Post-Acute and Long-Term Care Medicine, DOI: https://doi.org/10.1016/j.jamda.2018.10.013
Jerra Stemmle, MD, Alex Marzel, DrScNat, Patricia O. Chocano-Bedoya, MD, E. John Orav, PhD, Bess Dawson-Hughes, MD, Gregor Freystaetter, MD, Andreas Egli, MD, Robert Theiler, MD, Hannes B. Staehelin, MD, Heike A. Bischoff-Ferrari, MD, DrPH Heike.Bischoff at usz.ch MD, DrPH Heike A. Bischoff-Ferrari MD, DrPH Heike A. Bischoff-Ferrari
Very weird – Trial was to compare 800 IU vs 2,000 IU along with home exercise, but the 2,000 IU results are not mentioned in the abstract
- Vitamin D and fractures – 24 meta-analyses and counting – Dec 2014
- 1 in 3 died after hip fracture but only 1 in 14 if add Vitamin D and exercise – RCT April 2017
- After hip surgery Vitamin D levels dropped by 32 percent – Sept 2018
- Only 1600 IU of Vitamin D to be given following knee and hip replacement trial – 2020
- Vitamin D and exercise after hip fracture surgery – far fewer deaths – July 2016
- Elderly falls reduced 3.6 times by 900 IU of vitamin D and simple exercise – RCT Nov 2016
- 39% fewer falls with 2000 IU than 800 IU – RCT June 2010
- Seniors need at least 4,000 IU vitamin D, no test needed – Consensus Jan 2014
Probably the same RCT, but a different publication
Objectives: To evaluate 2 simple strategies, vitamin D3 and a home exercise program, in functional recovery during the first year after hip fracture.
Secondary analysis of a factorial clinical trial. Patients were randomly allocated to 800 IU (standard of care) or 2000 IU vitamin D3 and a daily instruction of a simple home exercise program (SHEP) or standard physiotherapy alone during acute care.
Setting and participants
Acute hip fracture patients aged ≥65 years, after hip fracture surgery, admitted to a large hospital in Zurich, Switzerland.
Three objective measures of lower extremity function were assessed at baseline and 6 and 12 months, with the Timed Up and Go test (TUG) as the primary endpoint, and knee flexor and extensor strength, and a self-reported physical function score (PF-10) as secondary endpoints. Linear mixed model regression analyses were based on intention to treat, adjusting for baseline function, time, age, sex, and baseline 25-hydroxyvitamin D level.
We enrolled 173 patients (79.2% women; mean age 84 years; 77.5% living at home). A significant interaction was found between vitamin D3 dose and SHEP for TUG (P = .045). Thus, findings compared the standard of care reference arm with 800 IU vitamin D3 without SHEP to 3 interventions arms (800 IU vitamin D3+SHEP; 2000 IU vitamin D3 without SHEP; 2000 IU vitamin D3+SHEP). For TUG, over 12 months the 800 IU vitamin D3+SHEP group performed significantly better than the standard-of-care group (13.8 vs 19.5 seconds; P = .01). Findings for knee flexor strength were in line with TUG results and approached significance (P = .07), whereas knee extensor strength and PF-10 did not differ by treatments.
For functional recovery after hip fracture, combining home exercise with 800 IU vitamin D3 is superior to no home exercise or 2000 IU vitamin D3. None of the interventions improved subjective physical functioning.