Min Kyunghoon, Beom Jaewon, Kim Bo Ryun, Lee Sang Yoon, Lee Goo Joo, Lee Jung Hwan, Lee Seung Yeol, Won Sun Jae, Ahn Sangwoo, Bang Heui Je, Cha Yonghan, Chang Min Cheol, Choi Jung-Yeon, Do Jong Geol, Do Kyung Hee, Han Jae-Young, Jang Il-Young, Jin Youri, Kim Dong Hwan, Kim Du Hwan, Kim In Jong, Kim Myung Chul, Kim Won, Lee Yun Jung, Lee In Seok, Lee In-Sik, Lee JungSoo, Lee Chang-Hyung, Lim Seong Hoon, Park Donghwi, Park Jung Hyun, Park Myungsook, Park Yongsoon, Ryu Ju Seok, Song Young Jin, Yang Seoyon, Yang Hee Seung, Yoo Ji Sung, Yoo Jun-Il, Yoo Seung Don, Choi Kyoung Hyo, Lim Jae-Young
Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Ann Rehabil Med. 2021 Jun;45(3):225-259. doi: 10.5535/arm.21110. Epub 2021 Jun 30.
OBJECTIVE: The incidence of hip fractures is increasing worldwide with the aging population, causing a challenge to healthcare systems due to the associated morbidities and high risk of mortality. After hip fractures in frail geriatric patients, existing comorbidities worsen and new complications are prone to occur. Comprehensive rehabilitation is essential for promoting physical function recovery and minimizing complications, which can be achieved through a multidisciplinary approach. Recommendations are required to assist healthcare providers in making decisions on rehabilitation post-surgery. Clinical practice guidelines regarding rehabilitation (physical and occupational therapies) and management of comorbidities/complications in the postoperative phase of hip fractures have not been developed. This guideline aimed to provide evidence-based recommendations for various treatment items required for proper recovery after hip fracture surgeries. METHODS: Reflecting the complex perspectives associated with rehabilitation post-hip surgeries, 15 key questions (KQs) reflecting the complex perspectives associated with post-hip surgery rehabilitation were categorized into four areas: multidisciplinary, rehabilitation, community-care, and comorbidities/complications. Relevant literature from four databases (PubMed, EMBASE, Cochrane Library, and KoreaMed) was searched for articles published up to February 2020. The evidence level and recommended grade were determined according to the grade of recommendation assessment, development, and evaluation method. RESULTS: A multidisciplinary approach, progressive resistance exercises, and balance training are strongly recommended. Early ambulation, weigh-bearing exercises, activities of daily living training, community-level rehabilitation, management of comorbidities/complication prevention, and nutritional support were also suggested. This multidisciplinary approach reduced the total healthcare cost. CONCLUSION: This guideline presents comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery.
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