Safety-promoting interventions for the older person with hip fracture on returning home: A systematic review

Background: Older adults with a prior history of falls that results in hip fractures have difficulties in regaining pre-fracture functional capacity. Scientific evidence has shown benefits of the implementation of multidimensional rehabilitation programs, but this evidence is not systematized with regard to continuity of care after hospital discharge. Objective: To identify interventions that promote safety and functional recovery of older adults with hip fractures after hospital discharge. Method: A systematic review was carried out according to Cochrane methodology. The research strategy was predefined for the MEDLINE and CINAHL databases. The identified articles were screened according to the eligibility criteria by two independent reviewers. The articles included in the bibliographic sample were eval-uated for risk of bias. Results: Of the 10,036 articles found, 10 were included in this systematic review. The safety-promoting in-terventions identified were: exercise training, occupational therapy/activities of daily living training, transfer and gait training, strengthening exercises, education on assistive device use, fall prevention education, nutri-tional assessment, environmental modifications/adjustments at home, use of an app, medication, self-care ed-ucation, and support and counseling. Conclusions: In eight studies analyzed, exercise training emerged as the most effective intervention for promoting the safety of older adults after hip fractures on returning home. Three studies associated two or more in-terventions, which focused on exercise training, occupational therapy/training of activities of daily living, and conventional postoperative rehabilitation with transfer and gait training, strengthening exercises, education on assistive device use and discharge planning, aiming to achieve muscle strengthening and safe gait, associated with the performance of activities of daily living.

Automated summary

This systematic review examined interventions for older adults with hip fractures after hospital discharge and found that exercise training emerged as the most effective intervention for promoting safety. Other interventions, such as occupational therapy, education, and environmental adjustments, were also found to promote functional recovery and daily living abilities.