Broken hip? Home-based rehabilitation may help get you moving again

The Bottom Line

  • Older adults who undergo surgery for a broken hip are at greater risk of long-term disability and a resulting decline in quality of life.
  • Rehabilitation programs designed to improve mobility, function, balance and strength help speed recovery and reduce the chance of long-term disability.
  • Programs delivered to post-surgery patients in their own homes appear to be as effective as those delivered in a medical care facility.

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).

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Author Details


  1. Crotty M, Unroe K, Cameron ID, et al. Rehabilitation interventions for improving physical and psychosocial functioning after hip fracture in older people. Cochrane Database of Systematic Reviews. 2010; article ID CD007624.
  2. Handoll HH, Cameron ID, Mak JC, et al. Multidisciplinary rehabilitation for older people with hip fractures. Cochrane Database of Systematic Reviews. 2009; article ID CD007125.
  3. Momsen AM, Rasmussen JO, Nielsen CV, et al. Multidisciplinary team care in rehabilitation: an overview of reviews. J Rehabil Med. 2012; 44:901-912.
  4. Cameron ID. Coordinated Multidisciplinary rehabilitation after hip fracture. Disabil Rehabil. 2005; 27:1081-1090.
  5. Hill KD, Hunter SW, Batchelor FA, et al. Individualized home-based exercise programs for older people to reduce falls and improve physical performance: A systematic review and meta-analysis. Maturitas. 2015; 82(1):72-84. doi: 10.1016/j.maturitas.2015.04.005. 
  6. Donohue K, Joevenaars R, McEachern J, et al. Home-based multidisciplinary rehabilitation following hip fracture surgery: What is the evidence? Rehabil Res Pract. 2013; 2013:875968.

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