Department of Orthopaedics, the Second Hospital, Shanxi Medical University, Taiyuan, China.
Department of Nursing, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Braz J Phys Ther. 2023 Jan-Feb;27(1):100482. doi: 10.1016/j.bjpt.2023.100482. Epub 2023 Jan 28.
Individuals commonly experience age-related systemic decreases in skeletal muscle strength, physical function, and mobility, leading to falls and potential associated hip fractures.
To evaluate whether intensive exercise can improve physical function, mobility, and independence in activities of daily living (ADL) and shorten the length of hospital stay in older adults after hip fracture surgery.
This systematic review was conducted under the PRISMA guidelines. Searches were performed on January 5, 2022 in eight databases. Randomized controlled trials (RCTs) were included. The participants included older adults with hip fracture, and the intervention studied was intensive exercise. The outcomes were physical function, mobility, ADLs, and the length of hospital stay. Meta-analyses were conducted using RevMan 5.3.
Fifteen studies were included in this review. After hip fracture surgery, intensive exercise improved participants' physical function to a greater extent than regular or no exercise (standardized mean difference [SMD] = 0.74; 95% CI: 0.25, 1.23). Intensive exercise was particularly more effective for gait speed (SMD = 0.15, 95% CI: 0.01, 0.30), the timed up-and-go test results (mean difference [MD] = -4.34, 95%CI: -6.74, -1.94), balance (SMD =0.42, 95% CI: 0.38, 0.89), and ADLs (SMD = 0.55, 95% CI: 0.24, 0.87). The quality of the evidence was low due to risk of bias, inconsistency, and imprecision.
Intensive exercise early post-operation provides potential additional benefits compared to no or regular exercises on older adults after hip fracture surgery.
个体通常会经历与年龄相关的骨骼肌力量、身体功能和活动能力下降，导致跌倒和潜在的髋部骨折相关风险。
评估强化运动是否能改善髋部骨折手术后老年人的身体功能、活动能力和日常生活活动（ADL）的独立性，并缩短住院时间。
本系统评价根据 PRISMA 指南进行。于 2022 年 1 月 5 日在八个数据库中进行了检索。纳入了随机对照试验（RCT）。研究对象为髋部骨折的老年人，研究干预为强化运动。结局指标为身体功能、活动能力、ADL 和住院时间。使用 RevMan 5.3 进行荟萃分析。
本综述纳入了 15 项研究。髋部骨折手术后，强化运动比常规运动或不运动更能显著改善参与者的身体功能（标准化均数差 [SMD] = 0.74；95%置信区间：0.25，1.23）。强化运动对步态速度（SMD = 0.15，95%置信区间：0.01，0.30）、计时起立行走测试结果（MD = -4.34，95%置信区间：-6.74，-1.94）、平衡（SMD = 0.42，95%置信区间：0.38，0.89）和 ADL（SMD = 0.55，95%置信区间：0.24，0.87）的改善效果更为显著。由于存在偏倚风险、不一致性和不精确性，证据质量较低。
与不运动或常规运动相比，髋部骨折手术后早期进行强化运动可为老年人提供潜在的额外益处。
