Hip fracture rehabilitation in hospital and community settings: A rapid review of the evidence

BackgroundProximal femoral or hip fracture is a common problem among older adults. With an increase in patients with hip fracture comes and increase in the number of patients who require post-surgery rehabilitation. Our aim was to review effectiveness of rehabilitation after hip fracture studies. MethodsFor this rapid review (RR) four databases, PubMed, PsycInfo, CINAHL and Cochrane Library, were searched for studies published between 1st January 2017 and 15th May 2023. The population were: people with hip fracture. Interventions: any hospital or community-based hip rehabilitation. Comparisons: improvements in function, and the outcomes were: physical function, quality of life and cost. FindingsSix studies were included in this RR which focussed on hip fracture rehabilitation programmes published since 2017. The studies were conducted in North America (USA), Europe (Germany, Austria, and Switzerland) and Asia (Hong Kong and China). Some randomised controlled trials and some cohort studies found beneficial effects of rehabilitation for older people who had undergone hip replacement treatments. The length of follow-up period ranged from 15 days to one year after surgery. Even though psychological distress, including loss of confidence and frustration, was the most important predictor of depression and anxiety in patients with hip fractures, only one study assessed anxiety and depression status of patients after surgery. It was not possible to combine the results in a meta-analysis as all the studies had different follow-up periods and used different outcome measures. InterpretationThe goal of achieving personalised rehabilitation treatment is possible and this concept of goal directed personalised rehabilitation should be developed and economically evaluated further. A strength of this review is that robust, recent, and relevant papers regarding rehabilitation following hip replacement were found and described. However, the main limitations were that none of the included studies conducted a cost-analysis of the intervention that they described, and no UK based study was included.