Maximising functional recovery following hip fracture in frail seniors.
This review discusses factors affecting recovery following hip fracture in frail older people as well as interventions associated with improved functional recovery. Prefracture function, cognitive status, co-morbidities, depression, nutrition and social support impact recovery and may interact to affect post-fracture outcome. There is mounting evidence that exercise is beneficial following hip fracture with higher-intensity/duration programmes showing more promising outcomes. Pharmacologic management for osteoporosis has benefits in preventing further fractures, and interest is growing in pharmacologic treatments for post-fracture loss of muscle mass and strength. A growing body of evidence suggests that sub-populations - those with cognitive impairment, residing in nursing homes or males - also benefit from rehabilitation after hip fracture. Optimal post-fracture care may entail the use of multiple interventions; however, more work is needed to determine optimal exercise components, duration and intensity as well as exploring the impact of multimodal interventions that combine exercise, pharmacology, nutrition and other interventions.
Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, University of Alberta, Edmonton, AB T6G 2G4, Canada. Electronic address: lauren.beaupre@ualberta.ca.
Lauren A
LA
Beaupre
Division of Geriatrics and Nutritional Science, Washington University School of Medicine, MO 4488 Forest Park Blvd, Suite 201, St. Louis, MO 63108, USA. Electronic address: EBinder@DOM.wustl.edu.
Ellen F
EF
Binder
Rehabilitation Studies Unit, Faculty of Medicine, University of Sydney, PO Box 6, Ryde, NSW 1680, Australia. Electronic address: ian.cameron@sydney.edu.au.
Ian D
ID
Cameron
Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, University of Alberta, Edmonton, AB T6G 2G4, Canada. Electronic address: cajones@ualberta.ca.
C Allyson
CA
Jones
Division of Gerontology, Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Suite 200, 660 West Redwood Street, Baltimore, MD 21030, USA. Electronic address: dorwig@epi.umaryland.edu.
Denise
D
Orwig
The George Institute for Global Health, Sydney Medical School, University of Sydney, NSW 2006, Australia. Electronic address: csherrington@george.org.au.
Cathie
C
Sherrington
Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Suite 200, 660 West Redwood Street, Baltimore, MD 21030, USA. Electronic address: jmagazin@epi.umaryland.edu.
Jay
J
Magaziner
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000534:rehabilitation; D005260:Female; D016330:Frail Elderly; D006620:Hip Fractures / Q000534:rehabilitation*; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009735:Nursing Homes; D058866:Osteoporotic Fractures / Q000534:rehabilitation*; D011788:Quality of Life; D020127:Recovery of Function
Cognitive impairment; Exercise; Frailty; Hip fracture; Pharmacological management; Rehabilitation