Physical exercise after hip fracture: an evidence overview

Improving strategies for hip fracture rehabilitation among older people is an urgent public health challenge due to the increasing proportion of older people in the global population and therefore the increasing numbers of falls and fractures. Most older people who suffer a hip fracture experience a permanent decrease in physical functioning. It is now clear in the general older population that muscle strength and balance can be improved and falls can be prevented by well-designed exercise programs. Physical exercise has the potential to improve physical outcomes after hip fracture in older people. Increasingly, clinicians are being urged to seek guidance from clinical trials in order to make clinical decisions. This article presents: 1) an overview of clinical practice guidelines and systematic reviews about rehabilitation after hip fracture and 2) an overview of randomised trials of exercise for people after hip fracture indexed on the Physiotherapy Evidence Database (PEDro). The lack of well-designed large-scale trials of exercise after hip fracture means that current guidelines do not include detailed recommendations about exercise after hip fracture. The Cochrane reviews covering this field also do not draw firm conclusions. However, several individual trials have had promising findings and indicate some benefits of exercise after hip fracture.