Abstract
Objective
To investigate the effect of rehabilitation on the physical, social, and psychological
dimensions of community reintegration after hip fracture.
Data Sources
Electronic databases Embase, EMCare, MEDLINE, PsycINFO, Cumulative Index to Nursing
and Allied Health, and SPORTDiscus were searched from the earliest date available
to second June 2021.
Study Selection
Searching identified 1844 potentially relevant articles. Twenty randomized controlled
trials evaluating physical retraining, cognitive retraining, and model of care interventions
on physical, social and psychological aspects of community reintegration for 3075
adults after hip fracture were included.
Data Extraction
Data were extracted using predetermined templates for participant characteristics,
intervention type and setting, and outcomes related to community reintegration. Methodological
quality was assessed using the Physiotherapy Evidence Database scale, and the Grading
of Recommendations, Assessment, Development, and Evaluations approach was applied
to each meta-analysis.
Data Synthesis
Post intervention data were pooled to calculate risk ratios (RRs), mean differences,
standardized mean differences, and 95% confidence intervals (CIs) using inverse variance
methods and a random-effects model. Compared with usual care or no rehabilitation,
there was moderate-quality evidence to suggest that physical retraining interventions
improved outdoor mobility (RR, 1.45; 95% CI, 1.09-1.91; I2=0%) and moderate-quality evidence to suggest that physical retraining improved Nottingham
Extended Activities of Daily Living Scale scores (physical and social reintegration)
by a mean 3.5 units (95% CI, 0.99-6.01; I2=0%). Meta-analyses showed no significant effect for cognitive retraining and model
of care interventions on any dimension of community reintegration.
Conclusions
Preliminary evidence suggests that physical rehabilitation after hip fracture improves
physical and social aspects of community reintegration. The effect of psychological
and home-based interventions on community reintegration is currently unclear. Further
research is needed to determine the effect of rehabilitation on community reintegration,
using interventions and measures that encompass all dimensions of community reintegration.
Keywords
List of abbreviations:
ADL (activities of daily living), FAI (Frenchay Activities Index), FES-I (Falls Efficacy Scale–International), GRADE (Grading of Recommendations, Assessment, Development, and Evaluations), MD (mean difference), NEADL (Nottingham Extended Activities of Daily Living), PEDro (Physiotherapy Evidence Database), RR (risk ratio), SMD (standardized mean difference)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 30, 2021
Accepted:
December 11,
2021
Received in revised form:
December 2,
2021
Received:
August 4,
2021
Footnotes
Disclosures: none
Identification
Copyright
© 2021 by the American Congress of Rehabilitation Medicine.
