Efficacy of Telerehabilitation Programs for Patients Undergoing Hip Fracture Surgery. Systematic Review
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Published:
Aug 20, 2024
Keywords:
Telerehabilitation, hip fracture, review
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Abstract
Introduction: Hip fracture is the leading cause of hospitalization in frail geriatric patients, due to osteoporosis and frequent falls. They affect 18% of women and 6% of men. The global number of hip fractures is expected to increase to 4.5 million by 2050. Surgery remains the predominant treatment of choice, and clinical practice guidelines recommend starting rehabilitation early. However, patients often have difficulty attending physical therapy clinics.
Objective: To evaluate the effectiveness of telerehabilitation programs for patients undergoing hip fracture surgery.
Materials and Methods: A review was carried out following the PRISMA guidelines. The databases of PubMed, Cinahl, PsycINFO, SPORTDiscus, Academic Search Complete, Lilacs, IBECS, CENTRAL, SciELO, and WOS were consulted. The Cochrane tool was used to assess the risk of bias.
Results: 59 articles were retrieved from all databases. After applying the inclusion criteria, 5 clinical studies remained. The total sample was 282 patients operated on for hip fractures. The total duration of telerehabilitation ranged from 3 to 12 weeks. All studies showed safety and good tolerability.
Conclusions: Telerehabilitation is effective in patients undergoing hip fracture surgery. This method improves mobility, quality of life, effectiveness of falls, anxiety, depression, and supports physical recovery to pre-fracture levels.
Objective: To evaluate the effectiveness of telerehabilitation programs for patients undergoing hip fracture surgery.
Materials and Methods: A review was carried out following the PRISMA guidelines. The databases of PubMed, Cinahl, PsycINFO, SPORTDiscus, Academic Search Complete, Lilacs, IBECS, CENTRAL, SciELO, and WOS were consulted. The Cochrane tool was used to assess the risk of bias.
Results: 59 articles were retrieved from all databases. After applying the inclusion criteria, 5 clinical studies remained. The total sample was 282 patients operated on for hip fractures. The total duration of telerehabilitation ranged from 3 to 12 weeks. All studies showed safety and good tolerability.
Conclusions: Telerehabilitation is effective in patients undergoing hip fracture surgery. This method improves mobility, quality of life, effectiveness of falls, anxiety, depression, and supports physical recovery to pre-fracture levels.
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Sánchez-Lozano, J., & Martínez-Pizarro, S. (2024). Efficacy of Telerehabilitation Programs for Patients Undergoing Hip Fracture Surgery. Systematic Review. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 89(4), 385-392. https://doi.org/10.15417/issn.1852-7434.2024.89.4.1942
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References
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randomized controlled trial. BMC Geriatr 2019;19(1):135. https://doi.org/10.1186/s12877-019-1141-z
19. Ortiz-Piña M, Molina-Garcia P, Femia P, Ashe MC, Martín-Martín L, Salazar-Graván S, et al. Effect of telerehabilitation compared with home-based in-person rehabilitation for older adult’s function after hip fracture. Int J Environ Res Public Health 2021;18(10):5493. https://doi.org/10.3390/ijerph18105493
20. Li CT, Hung GK, Fong KN, Gonzalez PC, Wah SH, Tsang HW. Effects of home-based occupational therapy
telerehabilitation via smartphone for outpatients after hip fracture surgery: A feasibility randomised controlled
study. J Telemed Telecare 2022;28(4):239-47. https://doi.org/10.1177/1357633X20932434
21. Mora-Traverso M, Prieto-Moreno R, Molina-Garcia P, Salas-Fariña Z, Martín-Martín L, Martín- Matillas M, et al.
Effects of the @ctivehip telerehabilitation program on the quality of life, psychological factors and fitness level of
patients with hip fracture. J Telemed Telecare 2024;30(3):549-58. https://doi.org/10.1177/1357633X211073256
22. Ariza-Vega P, Castillo-Pérez H, Ortiz-Piña M, Ziden L, Palomino-Vidal J, Ashe MC. The journey of recovery:
Caregivers’ perspectives from a hip fracture telerehabilitation clinical trial. Phys Ther 2021;101(3):pzaa220.
https://doi.org/10.1093/ptj/pzaa220
23. Tsuge T, Yamamoto N, Taito S, Miura T, Shiratsuchi D, Yorifuji T. Efficacy of telerehabilitation for patients after
hip fracture surgery: A systematic review and meta-analysis. J Telemed Telecare 2023 Jul 7:1357633X231181632.
https://doi.org/10.1177/1357633X231181632
24. Bramanti A, Ciurleo R, Vecchione C, Turolla A, Piramide N, Ciccarelli M, et al. Telerehabilitation: A solution for
patients after hip fracture? Transl Med UniSa 2024;26(1):30-7. https://doi.org/10.37825/2239-9747.1048
https://doi.org/10.1016/j.injury.2018.04.015
2. Bhandari M, Swiontkowski M. Management of acute hip fracture. N Engl J Med 2017;377(21):2053-62.
https://doi.org/10.1056/NEJMcp1611090
3. Brink O. Hip fracture clearance: How much optimisation is necessary? Injury 2020;51Suppl 2:S111-S117.
https://doi.org/10.1016/j.injury.2020.02.046
4. Li L, Bennett-Brown K, Morgan C, Dattani R. Hip fractures. Br J Hosp Med (Lond) 2020;81(8):1-10.
https://doi.org/10.12968/hmed.2020.0215
5. Dapaah D, Martel DR, Iranmanesh F, Seelemann C, Laing AC, Willett T. Fracture toughness: Bridging the gap
between hip fracture and fracture risk assessment. Curr Osteoporos Rep 2023;21(3):253-65.
https://doi.org/10.1007/s11914-023-00789-4
6. Katsanos S, Sioutis S, Reppas L, Mitsiokapa E, Tsatsaragkou A, Mastrokalos D, et al. What do hip fracture patients die from? Eur J Orthop Surg Traumatol 2023;33(4):751-7. https://doi.org/10.1007/s00590-022-03250-x
7. Loggers SAI, Van Lieshout EMM, Joosse P, Verhofstad MHJ, Willems HC. Prognosis of nonoperative treatment in
elderly patients with a hip fracture: A systematic review and meta-analysis. Injury 2020;51(11):2407-13.
https://doi.org/10.1016/j.injury.2020.08.027
8. Inoue T, Maeda K, Nagano A, Shimizu A, Ueshima J, Murotani K, et al. Undernutrition, sarcopenia, and frailty in
fragility hip fracture: Advanced strategies for improving clinical outcomes. Nutrients 2020;12(12):3743.
https://doi.org/10.3390/nu12123743
9. Fairhall NJ, Dyer SM, Mak JC, Diong J, Kwok WS, Sherrington C. Interventions for improving mobility after hip
fracture surgery in adults. Cochrane Database Syst Rev 2022;9(9):CD001704. https://doi.org/10.1002/14651858.CD001704.pub5
10. Griffiths R, Babu S, Dixon P, Freeman N, Hurford D, Kelleher E, et al. Guideline for the management of hip
fractures 2020: Guideline by the Association of Anaesthetists. Anaesthesia 2021;76(2):225-37.
https://doi.org/10.1111/anae.15291
11. Romero Pisonero E, Mora Fernández J. Multidisciplinary geriatric rehabilitation in the patient with hip fracture and dementia. Rev Esp Geriatr Gerontol 2019;54(4):220-9. https://doi.org/10.1016/j.regg.2018.11.001
12. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an
updated guideline for reporting systematic reviews. J Clin Epidemiol 2021;134:178-89. https://doi.org/10.1016/j.jclinepi.2021.03.001
13. Mamédio da Costa Santos C, Andrucioli de Mattos Pimenta C, Cuce Nobre MR. The PICO strategy for the research question construction and evidence research. Rev Lat Am Enfermagem 2007;15(3):508-11.
https://doi.org/10.1590/s0104-11692007000300023
14. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch WA (eds). Cochrane Handbook for
Systematic Reviews of Interventions. 2nd ed. Chichester (UK): John Wiley & Sons; 2019.
15. Aguayo-Albasini JL, Flores-Pastor B, Soria-Aledo V. Sistema GRADE: Clasificación de la calidad de la evidencia
y graduación de la fuerza de la recomendación. Cirugía Española 2014;92(2):82-8. https://doi.org/10.1016/j.ciresp.2013.08.002
16. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan—a web and mobile app for systematic reviews.
Syst Rev 2016;5(1):210. https://doi.org/10.1186/s13643-016-0384-4
17. Bedra M, Finkelstein J. Feasibility of post-acute hip fracture telerehabilitation in older adults. Stud Health Technol Inform 2015;210:469-73. PMID: 25991191
18. Gilboa Y, Maeir T, Karni S, Eisenberg ME, Liebergall M, Schwartz I, et al. Effectiveness of a tele- rehabilitation
intervention to improve performance and reduce morbidity for people post hip fracture study protocol for a
randomized controlled trial. BMC Geriatr 2019;19(1):135. https://doi.org/10.1186/s12877-019-1141-z
19. Ortiz-Piña M, Molina-Garcia P, Femia P, Ashe MC, Martín-Martín L, Salazar-Graván S, et al. Effect of telerehabilitation compared with home-based in-person rehabilitation for older adult’s function after hip fracture. Int J Environ Res Public Health 2021;18(10):5493. https://doi.org/10.3390/ijerph18105493
20. Li CT, Hung GK, Fong KN, Gonzalez PC, Wah SH, Tsang HW. Effects of home-based occupational therapy
telerehabilitation via smartphone for outpatients after hip fracture surgery: A feasibility randomised controlled
study. J Telemed Telecare 2022;28(4):239-47. https://doi.org/10.1177/1357633X20932434
21. Mora-Traverso M, Prieto-Moreno R, Molina-Garcia P, Salas-Fariña Z, Martín-Martín L, Martín- Matillas M, et al.
Effects of the @ctivehip telerehabilitation program on the quality of life, psychological factors and fitness level of
patients with hip fracture. J Telemed Telecare 2024;30(3):549-58. https://doi.org/10.1177/1357633X211073256
22. Ariza-Vega P, Castillo-Pérez H, Ortiz-Piña M, Ziden L, Palomino-Vidal J, Ashe MC. The journey of recovery:
Caregivers’ perspectives from a hip fracture telerehabilitation clinical trial. Phys Ther 2021;101(3):pzaa220.
https://doi.org/10.1093/ptj/pzaa220
23. Tsuge T, Yamamoto N, Taito S, Miura T, Shiratsuchi D, Yorifuji T. Efficacy of telerehabilitation for patients after
hip fracture surgery: A systematic review and meta-analysis. J Telemed Telecare 2023 Jul 7:1357633X231181632.
https://doi.org/10.1177/1357633X231181632
24. Bramanti A, Ciurleo R, Vecchione C, Turolla A, Piramide N, Ciccarelli M, et al. Telerehabilitation: A solution for
patients after hip fracture? Transl Med UniSa 2024;26(1):30-7. https://doi.org/10.37825/2239-9747.1048