title: Exercise, nutrition and managing hip fracture in older persons.
abstract: OBJECTIVE
  Lifestyle factors play a role in both the genesis and recovery from fragility fracture. The purpose of this review is to summarize recent evidence for exercise and nutrition in the management of hip fracture.
  
  
  RESULTS
  Recent randomized controlled trials of exercise have primarily consisted of isolated resistance training or multimodal home-based programs. More robust, long-term, or supervised training is generally associated with greater clinical benefits, including muscle strength, mobility, and function. Recent nutritional interventions have included multinutrient supplements, nutritional counseling and support, and vitamin D/calcium supplementation. Isolated nutritional interventions have not consistently shown significant impact on long-term outcomes after hip fracture, although improvements in body weight, biochemical indices, complication rates, and mobility have been reported. Overall, there is marked heterogeneity in the robustness of responses seen to hip fracture treatment studies. Few large, long-term, multicomponent interventions with clinically relevant outcomes of functional independence, need for residential care, mortality, and quality of life have been reported.
  
  
  CONCLUSIONS
  Evidence-based approaches to hip fracture should include comprehensive risk-factor assessment and treatment for sarcopenia/dynapenia, balance impairment, undernutrition of protein, energy, vitamin D and calcium, depression, cognitive impairment, sensory impairment, social isolation, and comorbid illness with exercise, nutrition and other modalities.
authors.affiliation: aExercise and Sport Science, Faculty of Health Sciences bSydney Medical School cUniversity of Sydney, New South Wales, Australia.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Fiatarone Singh
mesh_terms: D001835:Body Weight; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism; D002136:Calcium, Dietary / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D019587:Dietary Supplements; D019317:Evidence-Based Medicine; D015444:Exercise; D006620:Hip Fractures / Q000534:rehabilitation / Q000628:therapy*; D006801:Humans; D008019:Life Style; D044342:Malnutrition / Q000178:diet therapy; D009484:Neuropsychology; D009752:Nutritional Status; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D055948:Sarcopenia / Q000178:diet therapy; D014807:Vitamin D / Q000008:administration & dosage; D014812:Vitamin K / Q000008:administration & dosage
chemical_list: D002136:Calcium, Dietary; D004044:Dietary Proteins; D014812:Vitamin K; D014807:Vitamin D