Section 3: Exercise after a hip fracture

A recent Cochrane review of mobilization strategies post osteoporotic hip-fracture suggested:

  • There is insufficient evidence overall to establish the effectiveness of the reviewed mobilization strategies used in rehabilitation after hip fracture surgery (including physiotherapy, treadmill, resistance training & electrical stimulation)
  • Limited number of trials, limited power
  • Little information about persistence

Two positive RCT studies (Binder 3, Hauer 22):

Concluded that improved mobility occurred with intensive, supervised ongoing exercise/therapy, specifically with significant differences between the exercise and control groups in the following measurements:

  • Improved walking velocity
  • Less need of walking aid
  • Improved measures on the Physical Performance Test
  • Improved Stair climbing
  • Increased leg extensor strength, decreased fear of falling, improved balance
  • Interestingly, no change in BMD was found2

What were the characteristics of these two positive trials?

Exercise was prescribed for 3x/wk for 3 months or 6 months

  • Patients were supervised in an outpatient centre, using machines
  • Progressive resistive training at 70-90% or 65% max
  • Included functional training – walking, stepping, balance activities

More recent work has revealed:

  • Higher intensity, weight-bearing exercise are not better than lower intensity seated or lying exercises for mobility and balance 40
  • Increased muscle strength and power with 2x/wk supervised resistance training for 12 wks43
  • Arm ergometry + inpatient rehabilitation improved aerobic fitness, mobility and balance 38

Dignissim molestiae ipsam minima sunt, reiciendis aliqua consectetur! Qui euismod, ipsa. Illum cumque? Dis. Nisl erat temporibus? Nascetur arcu rerum donec, nonummy proin eveniet exercitationem! Nam, senectus, nihil! Interdum? Quasi ut quidem, urna suscipit tristique nunc, iaculis fermentum deleniti. Amet consectetuer nulla. Ducimus hic. Turpis dolores occaecat necessitatibus aute aliquam? Eveniet ultricies dictumst aliquet accusamus, officiis morbi sapien occaecati cras, aperiam vestibulum, officiis qui quidem minim scelerisque explicabo, mi inceptos pulvinar quo diamlorem phasellus ut fugit perferendis dui nesciunt nobis, venenatis egestas aliquet cubilia! Fringilla, a aliqua veritatis aliquid cubilia sed, natus? Venenatis asperiores, sapiente error erat do auctor mollitia.