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Physical Exercise After Fragility Fractures: A Systematic Review and Meta-Analysis of Function and Morbidity.
Rocío Segura Ruiz1, José Miguel Reyes-Martínez1, Emilia Priego-Cubero2
1Maimonides Institute of Biomedical Research of Córdoba (IMIBIC), Department of Nursing, Pharmacology and Physiotherapy, University of Córdoba, Reina Sofia University Hospital, 14004 Cordoba, Spain.
Structured exercise programs may improve physical function and reduce pain after fragility fractures in older adults. However, evidence for effects on falls and mortality is limited, with inconsistent results across studies.
Area of Science:
- Gerontology
- Rehabilitation Medicine
- Orthopedics
Background:
- Fragility fractures significantly impact older adults, leading to disability and loss of independence.
- Osteoporosis is a major risk factor for fragility fractures.
- The effectiveness of exercise rehabilitation post-fracture is not fully established.
Purpose of the Study:
- To systematically assess the impact of structured exercise programs on outcomes after fragility fractures.
- To evaluate effects on physical function, quality of life, falls, morbidity, and mortality.
- To synthesize evidence from randomized controlled trials and quasi-experimental studies.
Main Methods:
- Systematic review and meta-analysis following PRISMA guidelines.
- Searched multiple databases including MEDLINE, PubMed, EMBASE, Cochrane Library, CINAHL, and Web of Science.
- Included 26 studies with 4142 participants (mean age ~74.83 years, ~80.4% women) evaluating structured exercise programs (≥8 weeks) versus usual care.
Main Results:
- Exercise interventions, primarily multicomponent (strength, balance, mobility), improved physical function.
- A significant reduction in pain (QUALEFFO-41) was observed at 12 months (MD -11.61).
- Effects on strength, balance, and cognitive outcomes were inconsistent; evidence on falls and mortality was sparse.
Conclusions:
- Exercise-based rehabilitation shows potential for improving physical function and reducing pain after fragility fractures.
- Pooled effects are inconsistent and heterogeneous, limiting firm conclusions on falls and mortality.
- Physical function measures are practical primary endpoints but require cautious interpretation.
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