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

Kyunghoon Min, Jaewon Beom, Bo Ryun Kim, Sang Yoon Lee, Goo Joo Lee, Jung Hwan Lee, Seung Yeol Lee, Sun Jae Won, Sangwoo Ahn, Heui Je Bang, Yonghan Cha, Min Cheol Chang, Jung Yeon Choi, Jong Geol Do, Kyung Hee Do, Jae Young Han, Il Young Jang, Youri Jin, Dong Hwan Kim, Du Hwan KimIn Jong Kim, Myung Chul Kim, Won Kim, Yun Jung Lee, In Seok Lee, In Sik Lee, Jung Soo Lee, Chang Hyung Lee, Seong Hoon Lim, Donghwi Park, Jung Hyun Park, Myungsook Park, Yongsoon Park, Ju Seok Ryu, Young Jin Song, Seoyon Yang, Hee Seung Yang, Ji Sung Yoo, Jun Il Yoo, Seung Don Yoo, Kyoung Hyo Choi, Jae Young Lim

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

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.

Original languageEnglish
Pages (from-to)225-259
Number of pages35
JournalAnnals of Rehabilitation Medicine
Volume45
Issue number3
DOIs
StatePublished - 2021
Externally publishedYes

Keywords

  • Community Health Services
  • Hip fractures
  • Patient Care Team
  • Practice Guideline
  • Rehabilitation

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