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Systematic Review of Hip Fracture Rehabilitation Practices in the Elderly
Abstract
Objective To address the need for a research synthesis on the effectiveness of the full range of hip fracture rehabilitation interventions for older adults and make evidence based conclusions.Data sources Medline, PubMed, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials were searched from 1980 to 2007 for studies published in English. The terms rehabilitation and hip fracture were exploded in order to obtain related search terms and categories.Study selection In the initial search of the databases, a combined total of 1031 articles was identified. Studies that did not focus on hip fracture rehabilitation, did not include persons over the age of 50 years, and/or did not include measures of physical outcome were excluded.Data extraction Only studies with an Oxford Center for Evidence-Based Medicine Levels of Evidence level of I (randomized controlled trial, RCT) or II (cohort) were reviewed. The methodologic quality of both types of studies was assessed using a modified version of the Downs and Black checklist.Data synthesis There were 55 studies that met our selection criteria: 30 RCTs and 25 nonrandomized trials. They were distributed across 6 categories for rehabilitation intervention (care pathways, early rehabilitation, interdisciplinary care, occupational and physical therapy, exercise, intervention not specified) and 3 settings (acute care hospital, postacute care/rehabilitation, postrehabilitation).Conclusions When looking across all of the intervention types, the most frequently reported positive outcomes were associated with measures of ambulatory ability. Eleven intervention categories across 3 settings were associated with improved ambulatory outcomes. Seven intervention approaches were related to improved functional recovery, while 6 intervention approaches were related to improved strength and balance recovery. Decreased length of stay and increased falls self-efficacy were associated with 2 interventions, while 1 intervention had a positive effect on lower-extremity power generation.
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“For example, in the review by Chudyk et al, of the 55 included studies, only 5 reported on distress outcomes.91”
From Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: A scoping review of systematic reviews (2024) · cites this paper as [91]
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“Notably, when distress-related outcomes were reported in these systematic reviews, however, they were typically reported to improve.838587 90 91 93 96 98”
From Impact of healthcare interventions on distress following acute musculoskeletal/orthopaedic injury: A scoping review of systematic reviews (2024) · cites this paper as [91]
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Metadata
- Authors
- Chudyk, A. M., Jutai, J. W., Petrella, R. J., & Speechley, M.
- Affiliations
- Western University (CA)
- University of Ottawa (CA)
- Lawson Health Research Institute (CA)
- Corresponding author
- Chudyk, Anna M.
- Venue
- Archives of Physical Medicine and Rehabilitation
- Publisher
- Elsevier BV
- Published
- 2009-02
- Volume
- 90
- Issue
- 2
- Pages
- 246-262
- ISSN
- 0003-9993 (ISSN-L)
- OpenAlex
- W1985729539
- Cited by
- 213
- References
- 71
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 11 · 2023: 15 · 2022: 15 · 2021: 13 · 2020: 12 · 2019: 13 · 2018: 13 · 2017: 12 · 2016: 15 · 2015: 16 · 2014: 9 · 2013: 14 · 2012: 16
- FWCI
- 2.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Physical Medicine and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Hip and Femur Fractures
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone fractures and treatments
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Keywords
- hip fracture, rehabilitation, older adults, early rehabilitation, multidisciplinary care, physiotherapy, occupational therapy, physical activity, ambulatory function, functional recovery, balance, muscle strength, falls efficacy, length of hospital stay, post-acute care, care pathways
- MeSH terms
- Aged, Exercise Therapy, Hip Fractures, Humans, Inpatients, Middle Aged, Occupational Therapy, Outpatients, Postoperative Care, Time Factors, Walking, Critical Pathways, Evidence-Based Medicine, Physical Therapy Modalities, Interdisciplinary Communication
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