Cochrane · systematic review · CD001704
Interventions for improving mobility after hip fracture surgery in adults
Fairhall, NJ, Dyer, SM, Mak, JCS, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
Bone, Joint and Muscle TraumaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
26
current version
GRADE rated
21
No studies
2
Included studies
NR
No studies 2 · 7.7%Ungraded 3 · 11.5%Very low 3 · 11.5%Low 9 · 34.6%Moderate 5 · 19.2%High 4 · 15.4%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings: in‐hospital studies
Population: adults following hip fracture surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mobilityd ‐ overall analysis Using different mobility scales: MILA (range 0 to 36), EMS (range 0 to 20), BBS (range 0 to 56), PPME (range 0 to 12), Koval (range 1 to 7). Higher values indicate better mobility (except MILA and Koval, where scale wa... | SMD 0.53 [0.1, 0.96] | 7 studies · 507 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Walking speedg ‐ overall analysis Measured using metres/second (m/s) and metres/minute (m/min). A higher score indicates faster walking. | SMD 0.16 | 6 studies · 360 participants | Moderate Downgraded: risk of bias, imprecision |
Functioningi ‐ overall analysis Using different scales: mBI (range 0 to 20), BI (range 0 to 100), FIM (range 18 to 126), NEADL (range 0 to 66). A higher score indicates better functioning. | SMD 0.75 [0.24, 1.26] | 7 studies · 379 participants | Very low Downgraded: risk of bias, inconsistency |
HRQoL Using EQ‐5D (range 0 to 1) and HOOS (range 0 to 100). A higher score indicates better quality of life. | SMD 0.39 | 4 studies · 314 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Mortality | RR 1.06 [0.48, 2.3] | 6 studies · 489 participants | Low Downgraded: risk of bias, imprecision |
Adverse event: number of people who were re‐admitted | RR 0.7 [0.44, 1.11] | 4 studies · 322 participants | Low Downgraded: imprecision |
Number of people who returned to living at pre‐fracture residence | RR 1.07 [0.73, 1.56] | 2 studies · 240 participants | Low Downgraded: imprecision |
Summary of findings: different types of intervention on mobility outcome, in‐hospital
Population: adults following hip fracture surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mobility outcome | no estimate extracted | NR | No studies |
Mobility scales, using different mobility scales: MILA (range 0 to 36), EMS (range 0 to 20), BBS (range 0 to 56), PPME (range 0 to 12), Koval (range 1 to 7). Higher values indicate better mobility (except MILA and Koval, where scale was inverted f... | SMD 0.57 [0.07, 1.06] | 6 studies · 463 participants | Moderate Downgraded: inconsistency |
Mobility scales, using EMS (range 0 to 20). Higher values indicate better mobility | MD 1 | 1 study · 44 participants | Low Downgraded: risk of bias, imprecision |
TUG (lower score = faster) | no estimate extracted | 1 study · 74 participants | Low Downgraded: risk of bias, imprecision |
Summary of findings: post‐hospital studies
Population: adults following hip fracture surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mobilityd ‐ overall analysis Using different mobility scales: mPPT (range 0 to 36), POMA (range 0 to 30), SPPB (range 0 to 12), PPME (range 0 to 12). A higher score indicates better mobility. | SMD 0.32 [0.11, 0.54] | 7 studies · 761 participants | High |
Walking speedg ‐ overall analysis Measured using metres/second (m/s) and metres/minute (m/min). A higher score indicates faster walking. | SMD 0.16 [0.04, 0.29] | 14 studies · 1067 participants | High |
Functioningi ‐ overall analysis Using different functioning scales: FSQ (range 0 to 36), BI (range 0 to 100), AM‐PAC daily activity (range 9 to 101), COPM (range 0 to 20), LEFS (range 0 to 80), NEADL (range 0 to 66). A higher score indicates bette... | SMD 0.23 [0.1, 0.36] | 9 studies · 936 participants | High |
HRQoL using EQ‐ 5D (range 0 to 1), SF‐36 (range 0 to 100), SF‐12 (range 0 to 100), and WHOQOL‐BREF (range 0 to 130). A higher score indicates better quality of life. | SMD 0.14 [0, 0.29] | 10 studies · 785 participants | Moderate Downgraded: risk of bias |
Mortality | RR 1.01 [0.49, 2.06] | 8 studies · 737 participants | Moderate Downgraded: risk of bias, imprecision |
Adverse event: number of people who were re‐admitted | RR 0.86 [0.52, 1.42] | 2 studies · 206 participants | Low Downgraded: risk of bias, imprecision |
Summary of findings: different types of intervention on mobility outcome, post‐hospital
Population: adults following hip fracture surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mobility outcome | no estimate extracted | NR | No studies |
Mobility scales, using different scales: SPPB (range 0 to 12), PPME (range 0 to 12). A higher score indicates better mobility. | SMD 0.2 [0.05, 0.36] | 5 studies · 621 participants | High |
TUG (lower score = faster) | no estimate extracted | 1 study · 128 participants | Very low Downgraded: risk of bias, imprecision |
Minute Walk Test | no estimate extracted | 0 participants | Ungraded |
Mobility scales | no estimate extracted | 0 participants | Ungraded |
TUG | no estimate extracted | 1 study · 96 participants | Low Downgraded: imprecision |
6MWT | MD 55.65 [28.58, 82.72] | 3 studies · 198 participants | Low Downgraded: risk of bias, imprecision |
All | no estimate extracted | 0 participants | Ungraded |
Mobility scales, using different mobility scales: mPPT (range 0 to 36), POMA (range 0 to 30). | SMD 0.94 [0.53, 1.34] | 2 studies · 104 participants | Moderate Downgraded: imprecision |