Maximising functional recovery following hip fracture in frail seniors

Lauren A Beaupre; Ellen F Binder; Ian D Cameron; C Allyson Jones; Denise Orwig; Cathie Sherrington; Jay Magaziner

doi:10.1016/j.berh.2014.01.001

Maximising functional recovery following hip fracture in frail seniors

Best Pract Res Clin Rheumatol. 2013 Dec;27(6):771-88. doi: 10.1016/j.berh.2014.01.001.

Authors

Lauren A Beaupre¹, Ellen F Binder², Ian D Cameron³, C Allyson Jones⁴, Denise Orwig⁵, Cathie Sherrington⁶, Jay Magaziner⁷

Affiliations

¹ Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, University of Alberta, Edmonton, AB T6G 2G4, Canada. Electronic address: lauren.beaupre@ualberta.ca.
² Division of Geriatrics and Nutritional Science, Washington University School of Medicine, MO 4488 Forest Park Blvd, Suite 201, St. Louis, MO 63108, USA. Electronic address: EBinder@DOM.wustl.edu.
³ Rehabilitation Studies Unit, Faculty of Medicine, University of Sydney, PO Box 6, Ryde, NSW 1680, Australia. Electronic address: ian.cameron@sydney.edu.au.
⁴ Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, University of Alberta, Edmonton, AB T6G 2G4, Canada. Electronic address: cajones@ualberta.ca.
⁵ Division of Gerontology, Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Suite 200, 660 West Redwood Street, Baltimore, MD 21030, USA. Electronic address: dorwig@epi.umaryland.edu.
⁶ The George Institute for Global Health, Sydney Medical School, University of Sydney, NSW 2006, Australia. Electronic address: csherrington@george.org.au.
⁷ Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Suite 200, 660 West Redwood Street, Baltimore, MD 21030, USA. Electronic address: jmagazin@epi.umaryland.edu.

Abstract

This review discusses factors affecting recovery following hip fracture in frail older people as well as interventions associated with improved functional recovery. Prefracture function, cognitive status, co-morbidities, depression, nutrition and social support impact recovery and may interact to affect post-fracture outcome. There is mounting evidence that exercise is beneficial following hip fracture with higher-intensity/duration programmes showing more promising outcomes. Pharmacologic management for osteoporosis has benefits in preventing further fractures, and interest is growing in pharmacologic treatments for post-fracture loss of muscle mass and strength. A growing body of evidence suggests that sub-populations - those with cognitive impairment, residing in nursing homes or males - also benefit from rehabilitation after hip fracture. Optimal post-fracture care may entail the use of multiple interventions; however, more work is needed to determine optimal exercise components, duration and intensity as well as exploring the impact of multimodal interventions that combine exercise, pharmacology, nutrition and other interventions.

Keywords: Cognitive impairment; Exercise; Frailty; Hip fracture; Pharmacological management; Rehabilitation.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Aged
Aged, 80 and over
Cognition Disorders / rehabilitation
Female
Frail Elderly*
Hip Fractures / rehabilitation*
Homes for the Aged
Humans
Male
Nursing Homes
Osteoporotic Fractures / rehabilitation*
Quality of Life
Recovery of Function

Abstract

Publication types

MeSH terms

Grants and funding