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Clinical Practice Guideline for Postoperative Rehabilitation in Older Patients With Hip Fractures

Authors
  • Min, Kyunghoon
  • Beom, Jaewon
  • Kim, Bo Ryun
  • Lee, Sang Yoon
  • Lee, Goo Joo
  • Lee, Jung Hwan
  • Lee, Seung Yeol
  • Won, Sun Jae
  • Ahn, Sangwoo
  • Bang, Heui Je
  • Cha, Yonghan
  • Chang, Min Cheol
  • Choi, Jung-Yeon
  • Do, Jong Geol
  • Do, Kyung Hee
  • Han, Jae-Young
  • Jang, Il-Young
  • Jin, Youri
  • Kim, Dong Hwan
  • Kim, Du Hwan
  • And 22 more
Type
Published Article
Journal
Annals of Rehabilitation Medicine
Publisher
Korean Academy of Rehabilitation Medicine
Publication Date
Jun 30, 2021
Volume
45
Issue
3
Pages
225–259
Identifiers
DOI: 10.5535/arm.21110
PMID: 34233406
PMCID: PMC8273721
Source
PubMed Central
Keywords
Disciplines
  • Clinical Practice Guideline
License
Unknown

Abstract

Objective The incidence of hip fractures is increasing worldwide with the aging population, causing a challenge to healthcare systems due to the associated morbidities and high risk of mortality. After hip fractures in frail geriatric patients, existing comorbidities worsen and new complications are prone to occur. Comprehensive rehabilitation is essential for promoting physical function recovery and minimizing complications, which can be achieved through a multidisciplinary approach. Recommendations are required to assist healthcare providers in making decisions on rehabilitation post-surgery. Clinical practice guidelines regarding rehabilitation (physical and occupational therapies) and management of comorbidities/complications in the postoperative phase of hip fractures have not been developed. This guideline aimed to provide evidence-based recommendations for various treatment items required for proper recovery after hip fracture surgeries. Methods Reflecting the complex perspectives associated with rehabilitation post-hip surgeries, 15 key questions (KQs) reflecting the complex perspectives associated with post-hip surgery rehabilitation were categorized into four areas: multidisciplinary, rehabilitation, community-care, and comorbidities/complications. Relevant literature from four databases (PubMed, EMBASE, Cochrane Library, and KoreaMed) was searched for articles published up to February 2020. The evidence level and recommended grade were determined according to the grade of recommendation assessment, development, and evaluation method. Results A multidisciplinary approach, progressive resistance exercises, and balance training are strongly recommended. Early ambulation, weigh-bearing exercises, activities of daily living training, community-level rehabilitation, management of comorbidities/complication prevention, and nutritional support were also suggested. This multidisciplinary approach reduced the total healthcare cost. Conclusion This guideline presents comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery.

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