Key result
Resistance exercise improves hip function over usual care as the top strategy for elderly fracture patients.
Why the study?
Exercise intervention is promising and economical for elderly patients with hip fracture, but which exercise type is optimal remains unclear.
Do exercise interventions improve hip function and activities of daily living in elderly patients with hip fracture?
Meta-Analysis (n=3,286)
Do exercise interventions improve hip function and activities of daily living in elderly patients with hip fracture?
Effect estimate: MD -11.07 (95% CI -15.07 to -7.08)
Resistance exercise and balance exercise are the most effective exercise interventions for improving hip function, activities of daily living, and balance in elderly patients with hip fracture.
Resistance exercise should be prioritized in elderly hip fracture rehab; confirms its top ranking among exercise strategies for function.
Exercise intervention (EI) is a promising and economical way for elderly patients with hip fracture, but it is unclear which type of exercise is optimal. To assess the effectiveness of different EIs and identify the optimal EI of improving the prognosis for elderly patients with hip fracture. We searched Medline (via PubMed), Web of Science, Embase, Cochrane Central Register of Controlled Trials, CINAHL, CNKI, Wan Fang, VIP and CBM from their earliest records to June 2022. The included randomized controlled trials (RCT) included at least one type of exercise for patients with hip fracture. The methodological quality of these trials was assessed using the Cochrane Collaboration Risk of Bias Tool, Stata 14.0 software was used for NMA. The primary outcome was hip function, and the secondary outcomes were activity of daily living (ADL), walking capacity and balance ability of the patients. This study included 46 RCTs involving 3,286 patients. Based on the recovery of patients' hip function, resistance exercise (RE) ([MD]: -11.07, [Crl]: -15.07 to -7.08) showed significant benefits over the control group (CG). RE ([MD]: -8.86, [Crl]: -15.01 to -2.71) ([MD]: -9.09, [Crl]: -14.20 to -3.98) showed significant benefits over the weight-bearing exercise and aerobic exercise. In addition, RE (surface under cumulative ranking curve values [SUCRA]: 94.8%) and balance exercise (BE) ([SUCRA]: 81.1%) were most likely to be the optimal exercise methods for hip function recovery. BE may be the most effective exercise in improving ADL([SUCRA]: 98.4%) and balance ability([SUCRA]: 88.4%). These results suggest that RE and BE might be the best approach to improve prognosis for elderly patients with hip fracture. More well-designed and high-quality RCTs are needed to verify the conclusions drawn from this study.
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Pan et al. (2022) conducted a meta-analysis in Hip fracture in elderly patients (n=3,286). Resistance exercise vs. Usual care was evaluated on Hip function (MD -11.07, 95% CI -15.07 to -7.08). Resistance exercise significantly improved hip function compared to usual care (MD -11.07) and was ranked as the most effective exercise strategy for elderly patients with hip fracture.
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