Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, China.
Department of Tumor Chemoradiotherapy, Zhongnan Hospital of Wuhan University, Wuhan, China.
Int Wound J. 2020 Feb;17(1):45-54. doi: 10.1111/iwj.13230. Epub 2019 Nov 12.
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 home-based 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.
我们进行了一项荟萃分析，以评估髋部骨折后家庭运动方案对身体功能的影响。在 PubMed、EMBASE、CENTRAL 和 Cochrane 系统评价数据库中进行了计算机文献检索，以寻找发表的试验。选择了针对髋部骨折患者的基于家庭的运动方案与不进行基于家庭的运动的常规护理的随机试验。健康状况（通过短格式 36 测量）、正常步态速度、快速步态速度、平衡、工具性日常生活活动（IADL）、日常生活活动（ADL）、下肢力量、骨折腿的腿部力量、非骨折腿的腿部力量和 6 分钟步行测试（6MWT）每随机患者测量作为结果。共纳入了 11 项涉及 1068 名受试者的随机对照试验，其中 533 名受试者接受家庭运动方案，535 名受试者接受对照组。这项荟萃分析的结果表明，家庭运动方案与身体健康、正常步态速度、快速步态速度、平衡、IADL、ADL 和下肢力量无显著相关性，但与骨折腿的腿部力量、非骨折腿的腿部力量和 6MWT 显著相关。家庭运动方案对髋部骨折后身体功能有积极影响，但不显著。低强度训练和患者依从性差是家庭运动康复中不可避免的问题。更注重任务的康复方案可能会对残疾结果产生更大的益处。
