COMPARATIVE EFFECTS OF CLOSED KINETIC CHAIN EXERCISES AND MOBILIZATION EXERCISES IN ELDERLY FEMALES WITH NECK OF FEMUR FRACTURE

Background: Neck of femur fractures are among the most common hip injuries in elderly individuals, particularly postmenopausal women, due to osteoporosis and increased fall risk. These fractures significantly contribute to morbidity, functional disability, and mortality in older populations. Effective post-operative rehabilitation is crucial in restoring mobility, reducing pain, and preventing further complications in elderly females recovering from such fractures. Objective: This study aimed to compare the effects of Closed Kinetic Chain Exercises (CKCE) and Mobilization Exercises (ME) on pain intensity, hip joint range of motion (ROM), gait performance, and fall risk in elderly females with post-operative neck of femur fractures. Methods: A single-blinded randomized controlled trial was conducted over six months at a tertiary care hospital. A total of 49 elderly females aged ≥65 years with post-operative neck of femur fractures were initially enrolled; 44 participants completed the study. They were randomly assigned into two equal groups: Group A received Mobilization Exercises, and Group B received Closed Kinetic Chain Exercises. Both groups underwent 40-minute sessions, three times per week, for six weeks. Pain intensity, ROM, and risk of fall were assessed using the Visual Analogue Scale (VAS), goniometer, and Dynamic Gait Index (DGI), respectively. Data were analyzed using paired and independent t-tests after confirming normality with the Shapiro-Wilk test. Results: Group B (CKCE) showed a reduction in VAS from 8.07 ± 1.35 to 2.50 ± 1.44 and an increase in DGI from 9.82 ± 2.13 to 21.45 ± 1.99. Hip ROM improved post-intervention: flexion 97.91 ± 9.12, extension 20.73 ± 3.39, abduction 33.36 ± 3.55, adduction 32.50 ± 3.39, internal rotation 31.82 ± 3.91, external rotation 33.36 ± 3.55. Group A (ME) had VAS reduced from 6.58 ± 1.70 to 4.19 ± 1.80 and DGI improved from 11.23 ± 1.90 to 19.23 ± 1.99. Post-treatment ROM for Group A included: flexion 86.27 ± 9.43, extension 14.50 ± 2.57, abduction 29.64 ± 5.05, adduction 29.45 ± 5.61, internal rotation 26.95 ± 4.85, and external rotation 29.68 ± 5.18. Conclusion: While both interventions significantly improved outcomes, Closed Kinetic Chain Exercises were more effective in reducing pain, enhancing hip mobility, improving gait, and lowering fall risk in elderly females with post-operative neck of femur fractures.