TY - JOUR
T1 - Effectiveness of Supervised Home-Based Exercise Therapy Compared to a Control Intervention on Functions, Activities, and Participation in Older Patients After Hip Fracture
T2 - A Systematic Review and Meta-analysis
AU - Kuijlaars, Isolde A. R.
AU - Sweerts, Lieke
AU - Nijhuis-van der Sanden, Maria W. G.
AU - van Balen, Romke
AU - Staal, J. Bart
AU - van Meeteren, Nico L. U.
AU - Hoogeboom, Thomas J.
PY - 2019/1
Y1 - 2019/1
N2 - Objective: The aim of this review was to investigate whether supervised home-based exercise therapy after hospitalization is more effective on improving functions, activities, and participation in older patients after hip fracture than a control intervention (including usual care). Furthermore, we aimed to account the body of evidence for therapeutic validity.Data Sources: Systematic searches of Medline, Embase, and CINAHL databases up to June 30, 2016.Study Selection: Randomized controlled trials studying supervised home-based exercise therapy after hospitalization in older patients (>65y) after hip fracture.Data Extraction: Two reviewers assessed methodological quality (Physiotherapy Evidence Database) and therapeutic validity (Consensus on Therapeutic Exercise Training). Data were primary analyzed using a best evidence synthesis on methodological quality and meta-analyses.Data Synthesis: A total of 9 articles were included (6 trials; 602 patients). Methodological quality was high in 4 of 6 studies. One study had high therapeutic validity. We found limited evidence in favor of home-based exercise therapy for short- (4mo) performance based activities of daily living (ADL) and effects at long-term for gait (fast) and endurance. Evidence of no effectiveness was found for short- and long-term effects on gait and self-reported (instrumental) ADL and short-term effects on balance, endurance, and mobility. Conflicting evidence was found for strength, long-term balance, short-term gait (comfortable), long-term self-reported ADL, and long-term mobility.Conclusions: Research findings show no evidence in favor of home-based exercise therapy after hip fracture for most outcomes of functions, activities, and participation. However, trials in this field have low therapeutic validity (absence of rationale for content and intensity and reporting of adherence), which results in interventions that do not fit patients' limitations and goals. (C) 2018 by the American Congress of Rehabilitation Medicine
AB - Objective: The aim of this review was to investigate whether supervised home-based exercise therapy after hospitalization is more effective on improving functions, activities, and participation in older patients after hip fracture than a control intervention (including usual care). Furthermore, we aimed to account the body of evidence for therapeutic validity.Data Sources: Systematic searches of Medline, Embase, and CINAHL databases up to June 30, 2016.Study Selection: Randomized controlled trials studying supervised home-based exercise therapy after hospitalization in older patients (>65y) after hip fracture.Data Extraction: Two reviewers assessed methodological quality (Physiotherapy Evidence Database) and therapeutic validity (Consensus on Therapeutic Exercise Training). Data were primary analyzed using a best evidence synthesis on methodological quality and meta-analyses.Data Synthesis: A total of 9 articles were included (6 trials; 602 patients). Methodological quality was high in 4 of 6 studies. One study had high therapeutic validity. We found limited evidence in favor of home-based exercise therapy for short- (4mo) performance based activities of daily living (ADL) and effects at long-term for gait (fast) and endurance. Evidence of no effectiveness was found for short- and long-term effects on gait and self-reported (instrumental) ADL and short-term effects on balance, endurance, and mobility. Conflicting evidence was found for strength, long-term balance, short-term gait (comfortable), long-term self-reported ADL, and long-term mobility.Conclusions: Research findings show no evidence in favor of home-based exercise therapy after hip fracture for most outcomes of functions, activities, and participation. However, trials in this field have low therapeutic validity (absence of rationale for content and intensity and reporting of adherence), which results in interventions that do not fit patients' limitations and goals. (C) 2018 by the American Congress of Rehabilitation Medicine
KW - Community health services
KW - Elderly
KW - Exercise
KW - Hip fractures
KW - Rehabilitation
KW - PHYSICAL-THERAPY
KW - REHABILITATION
KW - PROGRAM
KW - RECOVERY
KW - ADULTS
KW - VALIDITY
KW - QUALITY
U2 - 10.1016/j.apmr.2018.05.006
DO - 10.1016/j.apmr.2018.05.006
M3 - Review article
VL - 100
SP - 101
EP - 114
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
SN - 0003-9993
IS - 1
ER -