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Meta-Analysis
. 2023 Jan-Feb;27(1):100482.
doi: 10.1016/j.bjpt.2023.100482. Epub 2023 Jan 28.

Effectiveness of intensive versus regular or no exercise in older adults after hip fracture surgery: A systematic review and meta-analysis

Fan Bai  1 , Minmin Leng  2 , Yan Zhang  3 , Jinli Guo  4 , Zhiwen Wang  5
Affiliations
Meta-Analysis

Effectiveness of intensive versus regular or no exercise in older adults after hip fracture surgery: A systematic review and meta-analysis

Fan Bai et al. Braz J Phys Ther. 2023 Jan-Feb.

Abstract

Background: Individuals commonly experience age-related systemic decreases in skeletal muscle strength, physical function, and mobility, leading to falls and potential associated hip fractures.

Objective: To evaluate whether intensive exercise can improve physical function, mobility, and independence in activities of daily living (ADL) and shorten the length of hospital stay in older adults after hip fracture surgery.

Methods: This systematic review was conducted under the PRISMA guidelines. Searches were performed on January 5, 2022 in eight databases. Randomized controlled trials (RCTs) were included. The participants included older adults with hip fracture, and the intervention studied was intensive exercise. The outcomes were physical function, mobility, ADLs, and the length of hospital stay. Meta-analyses were conducted using RevMan 5.3.

Results: Fifteen studies were included in this review. After hip fracture surgery, intensive exercise improved participants' physical function to a greater extent than regular or no exercise (standardized mean difference [SMD] = 0.74; 95% CI: 0.25, 1.23). Intensive exercise was particularly more effective for gait speed (SMD = 0.15, 95% CI: 0.01, 0.30), the timed up-and-go test results (mean difference [MD] = -4.34, 95%CI: -6.74, -1.94), balance (SMD =0.42, 95% CI: 0.38, 0.89), and ADLs (SMD = 0.55, 95% CI: 0.24, 0.87). The quality of the evidence was low due to risk of bias, inconsistency, and imprecision.

Conclusions: Intensive exercise early post-operation provides potential additional benefits compared to no or regular exercises on older adults after hip fracture surgery.

Keywords: High-intensity interval training; Hip fracture; Meta-analysis; Physical function.

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Conflict of interest statement

Conflicts of interest The authors declare that there are no potential conflicts of interest related to the study authors and corresponding organizations, and publication of the paper.

Figures

Fig 1
Fig. 1
Flow diagram of the study identification, selection, and inclusion processes.
Fig 2
Fig. 2
Risk of bias summary: review authors' judgements about risk of bias for each item for each included study (A) and risk of bias for each item presented as percentages across all included studies (B).
Fig 3
Fig. 3
Effect of intensive exercise on physical function after hip fracture surgery(A), effect of different intensive exercise based on load or duration on physical function after hip fracture surgery(B).
See this image and copyright information in PMC

References

    1. World Health Organization. Fact sheet. (2018-1-16). https://www.who.int/en/news-room/fact-sheets/detail/falls.
    1. Schaefer M.S., Hammer M., Platzbecker K., et al. What factors predict adverse discharge disposition in patients older than 60 years undergoing lower-extremity surgery? The Adverse Discharge in Older Patients after Lower-extremity Surgery (ADELES) risk score. Clin Orthop Relat Res. 2021;479(3):546–547. doi: 10.1097/CORR.0000000000001532. - DOI - PMC - PubMed
    1. Choi J.H., Kim B.R., Nam K.W., et al. Effectiveness of a Home-Based Fragility Fracture Integrated Rehabilitation Management (FIRM) program in patients surgically treated for hip fractures. J Clin Med. 2020;10(1):18. doi: 10.3390/jcm10010018. - DOI - PMC - PubMed
    1. Moseley A.M., Sherrington C., Lord S.R. Mobility training after hip fracture: a randomised controlled trial. Age Ageing. 2009;38(1):74–80. doi: 10.1093/ageing/afn217. - DOI - PubMed
    1. Portegijs E., Kallinen M., Rantanen T., et al. Effects of resistance training on lower-extremity impairments in older adults with hip fracture. Arch Phys Med Rehabil. 2008;89(9):1667–1674. doi: 10.1016/j.apmr.2008.01.026. - DOI - PubMed