Effect of Lower-Limb Progressive Resistance Exercise After Hip Fracture Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Studies

J Am Med Dir Assoc. 2017 Dec 1;18(12):1096.e19-1096.e26. doi: 10.1016/j.jamda.2017.08.021. Epub 2017 Oct 21.

Abstract

Objective: Although several studies have reported the effect of progressive resistance exercise (PRE) after hip fracture surgery, little is known about the functional efficacy of PRE. Thus, we conducted a meta-analysis to evaluate whether PRE can improve (1) mobility and (2) other physical functions in elderly patients after hip fracture surgery.

Methods: Eight randomized controlled trials investigating the effects of PRE after hip fracture surgery were retrieved from a PubMed, Embase, and Cochrane Library search. Our pair-wise meta-analysis used a fixed or random effects model.

Results: PRE significantly improved participants' overall physical functions after hip fracture surgery compared with the control group (standardized mean difference = 0.408; 95% confidence interval, 0.238-0.578; P < .001). It was particularly effective in the areas of mobility (standardized mean difference = 0.501; 95% confidence interval, 0.297-0.705; P < .001), activities of daily living, balance, lower-limb strength or power, and performance task.

Conclusions: Our meta-analysis revealed that PRE after hip fracture surgery improves mobility, activities of daily living, balance, lower-limb strength or power, and performance task outcomes. Because of the small sample size in this meta-analysis and considering the increasing incidence of hip fractures, there is a need for large-scale randomized controlled trials to confirm the functional improvement and adverse effects of PRE.

Keywords: Resistance training; hip fracture; meta-analysis; postoperative; rehabilitation.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Exercise Therapy
  • Female
  • Fracture Fixation, Internal / methods
  • Fracture Fixation, Internal / rehabilitation
  • Hip Fractures / diagnostic imaging
  • Hip Fractures / rehabilitation*
  • Hip Fractures / surgery*
  • Humans
  • Lower Extremity
  • Male
  • Muscle Strength / physiology*
  • Postural Balance / physiology
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Resistance Training / methods*
  • Task Performance and Analysis
  • Treatment Outcome