Department of Rehabilitation Science and Health Technology, OsloMet, Oslo, Norway.
Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
Osteoporos Int. 2024 Feb;35(2):203-215. doi: 10.1007/s00198-023-06922-4. Epub 2023 Oct 6.
Few older adults regain their pre-fracture mobility after a hip fracture. Intervention studies evaluating effects on gait typically use short clinical tests or in-lab parameters that are often limited to gait speed only. Measurements of mobility in daily life settings exist and should be considered to a greater extent than today. Less than half of hip fracture patients regain their pre-fracture mobility. Mobility recovery is closely linked to health status and quality of life, but there is no comprehensive overview of how gait has been evaluated in intervention studies on hip fracture patients. The purpose was to identify what gait parameters have been used in randomized controlled trials to assess intervention effects on older people's mobility recovery after hip fracture. This scoping review is a secondary paper that identified relevant peer-reviewed and grey literature from 11 databases. After abstract and full-text screening, 24 papers from the original review and 8 from an updated search and manual screening were included. Records were eligible if they included gait parameters in RCTs on hip fracture patients. We included 32 papers from 29 trials (2754 unique participants). Gait parameters were primary endpoint in six studies only. Gait was predominantly evaluated as short walking, with gait speed being most frequently studied. Only five studies reported gait parameters from wearable sensors. Evidence on mobility improvement after interventions in hip fracture patients is largely limited to gait speed as assessed in a controlled setting. The transition from traditional clinical and in-lab to out-of-lab gait assessment is needed to assess effects of interventions on mobility recovery after hip fracture at higher granularity in all aspects of patients' lives, so that optimal care pathways can be defined.
老年人髋部骨折后很少能恢复到骨折前的活动能力。评估对步态影响的干预研究通常使用短期临床测试或实验室参数，这些参数通常仅限于步态速度。日常生活环境中的移动性测量方法已经存在，应该比现在更广泛地考虑。只有不到一半的髋部骨折患者能恢复到骨折前的活动能力。活动能力的恢复与健康状况和生活质量密切相关，但目前还没有综合评估髋部骨折患者干预研究中步态评估的方法。本研究旨在确定在评估髋部骨折患者干预后恢复活动能力的随机对照试验中，使用了哪些步态参数。这是一项范围界定综述，从 11 个数据库中确定了相关的同行评议和灰色文献。经过摘要和全文筛选，从原始综述中纳入了 24 篇论文，从更新的搜索和手动筛选中纳入了 8 篇论文。如果这些论文包括髋部骨折患者 RCT 中的步态参数，则符合入选标准。我们纳入了 32 篇论文，来自 29 项试验（2754 名参与者）。仅有 6 项研究将步态参数作为主要终点。步态主要是通过短距离行走来评估的，其中步态速度是研究最多的。只有 5 项研究报告了可穿戴传感器的步态参数。髋部骨折患者干预后移动性改善的证据在很大程度上仅限于在受控环境中评估的步态速度。需要从传统的临床和实验室评估过渡到实验室外的步态评估，以便更全面地评估髋部骨折后干预对移动能力恢复的影响，从而确定最佳的护理路径。
