Is Occupational Therapy After Hip Fracture Surgery Effective in Improving Function?: A Systematic Review and Meta-Analysis of Randomized Controlled Studies

Am J Phys Med Rehabil. 2019 Apr;98(4):292-298. doi: 10.1097/PHM.0000000000001069.

Abstract

Objective: The aim of the study was to evaluate whether occupational therapy (OT) improves activities of daily living and overall physical functioning of patients after hip fracture surgery.

Data sources: The data sources are PubMed-Medline, Embase, and Cochrane Library databases.

Review methods: We searched for randomized controlled trials comparing occupational therapy with comprehensive postoperative care (without occupational therapy) after hip fracture surgery. A pairwise meta-analysis using fixed- and random-effects models was performed. The primary outcome of interest was performance of activities of daily living assessed in any manner. The secondary outcomes were other functional parameters: (1) physical function; (2) health perception and emotion; and (3) fall occurrence. Effect sizes were computed as standardized mean differences with 95% confidence intervals.

Results: Five randomized controlled trials including a total of 524 participants were retrieved. There was a trend toward improvement in activities of daily living, physical function, and fall occurrence, and these changes were not significant. However, health perception and patient emotions improved significantly in the occupational therapy group (standardized mean difference = 0.391, 95% confidence interval = 0.104 to 0.678, P = 0.008).

Conclusions: Occupational therapy after hip fracture surgery seems to improve overall function. Indeed, the positive effects of occupational therapy on health perception and emotions were evident. Therefore, occupational therapy can be suggested in comprehensive rehabilitation programs after hip fracture surgery.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Accidental Falls / statistics & numerical data
  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Female
  • Fracture Fixation / rehabilitation*
  • Hip Fractures / rehabilitation*
  • Hip Fractures / surgery
  • Humans
  • Male
  • Middle Aged
  • Occupational Therapy / methods*
  • Postoperative Care / methods*
  • Randomized Controlled Trials as Topic
  • Treatment Outcome