Hip fractures are common, particularly among older adults. The good news is that they can be treated with surgery. The bad news is that following surgery, older patients have a greater likelihood of experiencing long-term disability: they may become less mobile, less independent and as a result, less able to enjoy a good quality of life (1).
Post-surgery rehabilitation programs are designed to help speed recovery and reduce disability through exercises that improve movement, balance and strength (2). Studies have shown that multidisciplinary care – involving services provided by multiple health professionals such as physiotherapists, occupational therapists, nurses and social workers – is best for treating people who have suffered a broken hip (3;4).
What we don’t know for certain, however, is what setting is best for the delivery of such programs. Options include inpatient (at the hospital after surgery), outpatient (post-surgery appointments at the hospital or clinic) or at the patients homes after they’ve been discharged – usually early – from the hospital. We already know that personalized home-based exercise is a promising strategy for reducing falls and improving strength and balance in people living in the community (5). One systematic review of five randomized controlled trials attempted to explore this strategy in people recovering from a hip fracture. In particular, this review aimed to find out whether home-based multidisciplinary rehabilitation programs were effective in helping older adults resume the activities they enjoyed before the fracture (6).
What the research tells us
Based on the available data, home-based multidisciplinary rehabilitation programs help improve mobility, balance and strength in older adults after hip fracture surgery, at least in the short term.
Due to the low number and quality of the studies included in the review, further research is needed to confirm these findings and to learn more – such as the specific elements of an effective rehabilitation program. Meanwhile, it is encouraging that home-based programs appear to be at least as effective as those delivered in inpatient and outpatient settings and provide patients with an additional option for care (6).