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Extended Exercise Rehabilitation After Hip Fracture Improves Patients' Physical Function: A Systematic Review and Meta-Analysis.
MedLine Citation:
PMID:  22822235     Owner:  NLM     Status:  Publisher    
BackgroundAlthough the principal goal of hip fracture management is a return to the pre-event functional level, most survivors fail to regain their former levels of autonomy. One of the most effective strategies to mitigate the fracture's consequences is therapeutic exercise. PURPOSE: /b>The purpose of this study was to review and quantify the reported effects of an extended exercise rehabilitation program offered beyond the regular rehabilitation period on improving physical functioning for patients with hip fractures.SourcesThe Cochrane libraries, PubMed, CINAHL, PEDro, and EMBASE were searched to April 2012.Study SelectionAll randomized controlled trials comparing extended exercise programs with usual care for community-dwelling people after hip fracture were included in the review.Data Extraction and SynthesisTwo reviewers conducted each step independently. The data from the included studies were summarized, and pooled estimates were calculated for 11 functional outcomes. RESULTS: /b>Thirteen trials were included in the review and 11 in the meta-analysis. The extended exercise program showed modest effect sizes (ESs), which reached significance, under random theory, for knee extension strength for the affected and nonaffected sides (ES=0.47, 95% confidence interval [CI]=0.27-0.66, and 0.45, 95% CI=0.16-0.74, respectively); balance (ES=0.32, 95% CI=0.15-0.49); physical performance-based tests (ES=0.53, 95% CI=0.27-0.78); Timed "Up & Go" Test (ES=0.83, 95% CI=0.28-1.4); and fast gait speed (ES=0.42, 95% CI=0.11-0.73). Effects on normal gait speed, Six-Minute Walk Test, activities of daily living and instrumental activities of daily living, and 36-Item Short-Form Health Survey physical function scale (SF-36-PF) did not reach significance. Community-based programs had larger ESs compared with home-based programs. CONCLUSIONS:/b>To the authors' knowledge, this is the first meta-analysis to provide evidence that an extended exercise rehabilitation program for patients with hip fractures has a significant impact on various functional abilities. The focus of future research should go beyond just effectiveness and study the cost-effectiveness of extended programs.
Mohammad Auais; Owis Eilayyan; Nancy E Mayo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-19
Journal Detail:
Title:  Physical therapy     Volume:  -     ISSN:  1538-6724     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0022623     Medline TA:  Phys Ther     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
M. Auais, PT, MSc, School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Quebec, Ontario, Canada. Mailing address: Ross Pavillion, Royal Victoria Hospital, 687, Avenue des Pins West, R4.29, Montreal, Quebec, Canada H3A 1A1.
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