Exercise Therapy Is Effective at Improving Short- and Long-Term Mobility, Activities of Daily Living, and Balance in Older Patients Following Hip Fracture: a systematic review and meta-analysis

Signe Hulsbæk, Carsten Juhl, Alice Røpke, Thomas Bandholm, Morten Tange Kristensen

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

BACKGROUND: A systematic review and meta-analysis was performed to evaluate the short- and long-term effects of exercise therapy on physical function, independence, and well-being in older patients following hip fracture and, secondly, whether the effect was modified by trial-level characteristics such as intervention modality, duration, and initiation timepoint.

METHOD: Medline, CENTRAL, Embase, CINAHL, and PEDro were searched up to November 2020. Eligibility criteria were randomized controlled trials investigating the effect of exercise therapy on physical function, independence, and well-being in older patients following hip fracture, initiated from time of surgery up to 1 year.

RESULTS: Forty-nine studies involving 3 905 participants showed a small-to-moderate effect of exercise therapy at short term (end of intervention) on mobility (standardized mean difference [SMD] 0.49, 95% confidence interval [CI]: 0.22-0.76); activities of daily living (ADL) (SMD 0.31, 95% CI: 0.16-0.46); lower limb muscle strength (SMD 0.36, 95% CI: 0.13-0.60); and balance (SMD 0.34, 95% CI: 0.14-0.54). At long term (closest to 1 year), small-to-moderate effects were found for mobility (SMD 0.74, 95% CI: 0.15-1.34), ADL (SMD 0.42, 95% CI: 0.23-0.61), balance (SMD 0.50, 95% CI: 0.07-0.94), and health-related quality of life (SMD 0.31, 95% CI: 0.03-0.59). Certainty of evidence was evaluated using Grading of Recommendations Assessment, Development and Evaluation ranging from moderate to very low, due to study limitation and inconsistency.

CONCLUSION: We found low certainty of evidence for a moderate effect of exercise therapy on mobility in older patients following hip fracture at end of treatment and follow-up. Further, low evidence was found for small-to-moderate short-term effect on ADL, lower limb muscle strength and balance.

CLINICAL TRIALS REGISTRATION NUMBER: CRD42020161131.

Original languageEnglish
JournalJournals of Gerontology. Series A: Biological Sciences & Medical Sciences
Volume77
Issue number4
Pages (from-to)861-871
ISSN1079-5006
DOIs
Publication statusPublished - Apr 2022

Keywords

  • Activities of Daily Living
  • Aged
  • Exercise Therapy
  • Hip Fractures/therapy
  • Humans
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Exercise
  • Occupational therapy
  • Rehabilitation
  • Physical function
  • Physical therapy

Fingerprint

Dive into the research topics of 'Exercise Therapy Is Effective at Improving Short- and Long-Term Mobility, Activities of Daily Living, and Balance in Older Patients Following Hip Fracture: a systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this