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

Chen, Bin; Nie, Hu; Tan, Jun

doi:10.1111/iwj.13230

Cited by 22 publications

(34 citation statements)

References 27 publications

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“…Over recent decades other models of home-based rehabilitation (HBR) have been developed in addition to the classical model. Two systematic reviews were published recently ( 8 , 9 ) that evaluated the effectiveness of HBR for patients with fractures of the femoral neck, but most studies included in the review related to ongoing rehabilitation processes and not intensive rehabilitation immediately after surgery. Table 1 shows a summary of the main findings of six studies ( 10 – 15 ) that compared the effectiveness of HBR with that of standard inpatient rehabilitation (IR).…”

Section: Introductionmentioning

confidence: 99%

Intensive Inpatient vs. Home-Based Rehabilitation After Hip Fracture in the Elderly Population

et al. 2020

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Background: As the population ages, the rate of hip fractures and the need for rehabilitation increases. Home-based rehabilitation (HBR) is an alternative to classic inpatient rehabilitation (IR), which is an expensive framework with non-negligible risks. Methods: A retrospective study of patients 65 years and above following surgery to repair a hip fracture who underwent HBR or IR between 2016 and 2019. The two rehabilitation frameworks were compared for rehabilitation outcome and factors predicting successful rehabilitation. The outcome was determined with the Montebello Rehabilitation Factor Score-Revised (MRFS-R). Results: Data were collected for 235 patients over 3 years. The mean age was 81.3 ± 8.0 and 172 (73.3%) were women. Of these, 138 underwent IR and 97 HBR. The HBR group had better family support and fewer lived alone. There were also differences in the type of fracture and surgery. The medical condition of the IR group was more complex, as reflected in a higher Charlson's comorbidity scores, higher rates for delirium and more infectious complications, a lower Norton score, lower serum hemoglobin, and albumin levels, and higher serum creatinine and urea levels. It also had a more significant functional decline after surgery and required a longer rehabilitation period. However, no difference was found in the rehabilitation outcomes between the two groups (MRFS-R ≥ 50). The independent predictors for rehabilitation in the IR group were serum albumin level, comorbidity, and cognitive state. There were no independent predictors in the HBR group. Conclusions: In this retrospective study, there was no significant difference in short-term rehabilitation outcomes between the HBR and IR groups event though the patients in the IR group were medically more complex. This result should be taken into account when planning rehabilitation services after hip fracture and tailoring rehabilitation frameworks to patients.

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Section: Introductionmentioning

confidence: 99%

Intensive Inpatient vs. Home-Based Rehabilitation After Hip Fracture in the Elderly Population

et al. 2020

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“…Nevertheless, additional studies need to be conducted to determine the clinical significance of balance training. Chen et al [ 25 ] found that a home-based exercise program had a positive, although not significant, effect on physical function after hip fracture.…”

Section: Discussionmentioning

confidence: 99%

Balance training can enhance hip fracture patients’ independence in activities of daily living

Chen

Yang²,

Wang³

2020

Medicine

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Background: We conducted this meta-analysis to analyze the effectiveness of balance training in improving postoperative rehabilitation outcomes in hip fracture surgery patients. Methods: The Cochrane Library, Web of Science, Embase, and PubMed electronic databases were searched from their inception to December 2018. We selected prospective clinical control analyses and high-quality randomized controlled trials (RCTs) following the inclusion standards. We used Stata 12.0 to perform the meta-analysis. Where possible, the standard mean difference (SMD) with the 95% confidence interval (CI) was determined using a random effects model. Results: Ten RCTs involving 955 hips (balance training = 487, control = 468) published between 2002 and 2019 were assessed for eligibility of inclusion in the meta-analysis. Balance training was shown to remarkably improve the aspects of quality of life associated with physical health (standard mean difference [SMD], 2.20; 95% CI, 1.63–2.78, P = .000), a fast gait speed (SMD, 1.01; 95% CI, 0.25–1.77, P = .009), and balance (SMD = 0.26, 95% CI: [0.12, 0.41], P = .000). Moreover, the balance training group showed increases in independence in activities of daily living (ADLs), performance task scores, and health-related quality of life (HRQoL) scores compared with the control group ( P < .05). Conclusion: According to the present meta-analysis, balance training improves one's independence in activities of daily living, performance tasks, lower limb strength, gait, and total physical function compared with no balance training. More high-quality RCTs with large sample sizes are required for the identification of the best balance training program after hip fracture.

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“…Over the last decade, many scholars have conducted extensive research in the area of post-operative rehabilitation of hip fracture patients [4]. Different exercises and activity movements to be performed during rehabilitation have been proposed [16,17].…”

Section: Related Workmentioning

confidence: 99%

“…It plays a pivotal role in restoring physical functionality, healing the injured hip, and supporting muscle strength. Evidence shows that intensive rehabilitation plays a role in functional performance, quality of life, and achieving optimal rehabilitation outcomes [2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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IoT-Based Patient Movement Monitoring: The Post-Operative Hip Fracture Rehabilitation Model

Gupta

Al-Anbuky

2021

Future Internet

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Hip fracture incidence is life-threatening and has an impact on the person’s physical functionality and their ability to live independently. Proper rehabilitation with a set program can play a significant role in recovering the person’s physical mobility, boosting their quality of life, reducing adverse clinical outcomes, and shortening hospital stays. The Internet of Things (IoT), with advancements in digital health, could be leveraged to enhance the backup intelligence used in the rehabilitation process and provide transparent coordination and information about movement during activities among relevant parties. This paper presents a post-operative hip fracture rehabilitation model that clarifies the involved rehabilitation process, its associated events, and the main physical movements of interest across all stages of care. To support this model, the paper proposes an IoT-enabled movement monitoring system architecture. The architecture reflects the key operational functionalities required to monitor patients in real time and throughout the rehabilitation process. The approach was tested incrementally on ten healthy subjects, particularly for factors relevant to the recognition and tracking of movements of interest. The analysis reflects the significance of personalization and the significance of a one-minute history of data in monitoring the real-time behavior. This paper also looks at the impact of edge computing at the gateway and a wearable sensor edge on system performance. The approach provides a solution for an architecture that balances system performance with remote monitoring functional requirements.

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

Cited by 22 publications

References 27 publications

Intensive Inpatient vs. Home-Based Rehabilitation After Hip Fracture in the Elderly Population

Intensive Inpatient vs. Home-Based Rehabilitation After Hip Fracture in the Elderly Population

Balance training can enhance hip fracture patients’ independence in activities of daily living

IoT-Based Patient Movement Monitoring: The Post-Operative Hip Fracture Rehabilitation Model

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