TY - JOUR

T1 - Exercise therapy is effective at improving short- and long-term mobility, ADL and balance in older patients following hip fracture

T2 - a systematic review and meta-analysis

AU - Hulsbæk, Signe

AU - Juhl, Carsten

AU - Røpke, Alice

AU - Bandholm, Thomas

AU - Kristensen, Morten Tange

PY - 2022

Y1 - 2022

N2 - BackgroundA 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.MethodMedline, 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.ResultsForty-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.ConclusionWe 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.

AB - BackgroundA 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.MethodMedline, 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.ResultsForty-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.ConclusionWe 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.

U2 - 10.1093/gerona/glab236

DO - 10.1093/gerona/glab236

M3 - Review

C2 - 34387664

VL - 77

SP - 861

EP - 871

JO - Journals of Gerontology. Series A: Biological Sciences & Medical Sciences

JF - Journals of Gerontology. Series A: Biological Sciences & Medical Sciences

SN - 1079-5006

IS - 4

ER -