Effect of Lower-Limb Progressive Resistance Exercise After Hip Fracture Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Studies

Lee, Sang Yoon; Yoon, Byung‐Ho; Beom, Jaewon; Ha, Yong‐Chan; Lim, Jae‐Young

doi:10.1016/j.jamda.2017.08.021

Cited by 65 publications

(61 citation statements)

References 28 publications

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“…Meanwhile, continuous rehabilitation guidance plays a crucial role in deciding whether the patient can achieve independence in functioning and regain self‐care ability. Physiotherapy after hip fracture aims to improve mobility, strength, balance, and reverse physical deconditioning . Therefore, in addition to surgical treatment, postoperative rehabilitation exercises for elderly patients with hip fractures have received more and more attention.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of home‐based exercise programme on physical function after hip fracture: a systematic review and meta‐analysis of randomised controlled trials

Chen

Nie

Tan

2019

International Wound Journal

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We performed a meta-analysis to evaluate the effect of home exercise programmes on body function after hip fractures. A computerised literature search was performed for published trials in PubMed, EMBASE, CENTRAL, and Cochrane Database of Systematic Reviews. Randomised trials were selected investigating home-based exercise programmes vs usual care without home-based exercise in hip fracture patients. Physical health (measured by Short Form 36), normal gait speed, fast gait speed, balance, instrumental activities of daily living (IADL), activities of daily living (ADL), lower extremity strength, leg strength in fractured leg, leg strength in non-fractured leg, and Six-Minute Walk Test (6MWT) per randomised patient were measured as outcomes. Eleven randomised controlled trials of 1068 subjects were included, 533 in the homebased exercise group and 535 in the control group. The results of this meta-analysis showed that the home-based exercise programmes were not significantly associated with physical health, normal gait speed, fast gait speed, balance, IADL, ADL, and lower extremity strength but were significantly associated with leg strength in the fractured leg, leg strength in the non-fractured leg, and 6MWT. The home-based exercise programme had a positive, although not significant, effect on physical function after hip fracture. Low-intensity training and poor patient compliance are unavoidable problems in home-based exercise rehabilitation. A more task-oriented rehabilitation programme might possibly yield more benefits for disability outcomes.

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Section: Introductionmentioning

confidence: 99%

Efficacy of home‐based exercise programme on physical function after hip fracture: a systematic review and meta‐analysis of randomised controlled trials

Chen

Nie

Tan

2019

International Wound Journal

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“…Data were extracted from 1 review of systematic reviews, 17 systematic reviews, 1 narrative review, 20 RCTs, one quasi-RCT and 3 non-randomised studies. Meta-analyses for outcomes of interest were available in 9 papers,24–32 with participant numbers from 11624 to 19 519 25. Sample size of primary studies varied from 6229 participants33 to 70 participants 34.…”

Section: Resultsmentioning

confidence: 99%

Prevention and management of osteoporotic fractures by non-physician health professionals: a systematic literature review to inform EULAR points to consider

et al. 2020

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ObjectiveTo perform a systematic literature review (SLR) about the effect of non-pharmacological interventions delivered by non-physician health professionals to prevent and manage osteoporotic fractures.MethodsEight clinical questions based on two criteria guided the SLR: (1) adults≥50 years at high risk of osteoporotic fracture and (2) interventions delivered by non-physician health professionals to prevent and manage osteoporotic fractures. Interventions focused on diagnostic procedures to identify risk of falling, therapeutic approaches and implementation strategies. Outcomes included fractures, falls, risk of falling and change in bone mineral density. Systematic reviews and randomised controlled trials were preferentially selected. Data were synthesised using a qualitative descriptive approach.ResultsOf 15 917 records, 43 articles were included. Studies were clinically and methodologically diverse. We identified sufficient evidence that structured exercise, incorporating progressive resistance training delivered to people who had undergone hip fracture surgery, and multicomponent exercise, delivered to people at risk of primary fracture, reduced risk of falling. The effectiveness of multidisciplinary fracture liaison services in reducing refracture rate was confirmed. There was insufficient evidence found to support the effectiveness of nutrients and falls prevention programmes in this patient population.ConclusionDespite study heterogeneity, our SLR showed beneficial effects of some interventions delivered by non-physician health professionals and the positive impact of multidisciplinary team working and patient educational approaches to prevent and manage osteoporotic fractures. These results informed a EULAR taskforce that developed points to consider for non-physician health professionals to prevent and manage osteoporotic fractures.

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“…Third, muscle weakness is a modifiable risk factor that can be improved. It is well know that strengthening exercises had favorable effects on various outcomes after hip fracture [30]. Therefore, future studies should reveal if patients with clinically defined weakness who sustain a hip fracture could benefit from interventions to improve muscle strength, function, and outcomes.…”

Section: Discussionmentioning

confidence: 99%

Can early assessment of hand grip strength in elderly hip fracture patients predict functional outcome?

Selakovic¹,

Dubljanin-Raspopovic

Marković-Denić

et al. 2019

Preprint

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Decreased muscle strength is not only a risk factor for hip fracture in elderly patients, but plays a role in recovery of physical function. Our aim was to assess the role of grip strength measured early after hip fracture, and classified according to the EWGSOP2 criteria in predicting short- and long-term functional recovery. One hundred ninety-one patients with acute hip fracture consecutively admitted to an orthopaedic hospital have been selected. A multidimensional geriatric assessment evaluating sociodemographic variables, cognitive status, functional status and quality of life prior to fracture, as well as perioperative variables were performed. Follow-ups at 3 and 6 months after surgery were carried out to evaluate functional recovery. Multivariate regression models were used to assess the predictive role of handgrip strength. The mean age of the participants was 80.3 ±6.8 years. Thirty-five percent of our patients with clinically relevant hand grip strength weakness were significantly older, more often female, had a lower BMI, and were of worse physical health. They also had a lower cognitive level, lower Barthel index, and lower EQ5D scores before fracture. Multivariate regression analysis adjusted for age and gender revealed that hand grip weakness was an independent predictor of worse functional outcome at 3 and 6 months after hip fracture for both genders and in all age populations. Our study supports the prognostic role of hand grip strength assessed at hospital admission in patients with hip fracture. Thus, clinicians should be encouraged to include hand grip assessment in their evaluation of hip fracture patients in the acute setting in order to optimize treatment of high-risk individuals.

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Effect of Lower-Limb Progressive Resistance Exercise After Hip Fracture Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Studies

Cited by 65 publications

References 28 publications

Efficacy of home‐based exercise programme on physical function after hip fracture: a systematic review and meta‐analysis of randomised controlled trials

Efficacy of home‐based exercise programme on physical function after hip fracture: a systematic review and meta‐analysis of randomised controlled trials

Prevention and management of osteoporotic fractures by non-physician health professionals: a systematic literature review to inform EULAR points to consider

Can early assessment of hand grip strength in elderly hip fracture patients predict functional outcome?

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