Preoperative exercise training in the pre-rehabilitation of elderly patients with hip fracture: a scoping review_West China Medical Journal

Authors：

PENG Tao , HE Yongqin , YI Dekun , ZHOU Yuanyuan ,  ZHANG Yumei

Department of Orthopedics, the Second Affiliated Hospital of Army Medical University, Chongqing 400037, P. R. China;

Corresponding?author：

ZHANG Yumei, Email: zhangyumei19693@sina.com

Keywords：

Elderly; hip fracture; preoperative exercise; pre-rehabilitation; scoping review

DOI：

10.7507/1002-0179.202402154

Video：

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Objective To systematically analyze the relevant research on the application of preoperative exercise training in the pre-rehabilitation of elderly hip fracture patients, identify the specific content, outcome indicators, and application effects of exercise intervention, in order to provide reference for medical staff to carry out relevant interventions. Methods Computer searches were conducted on domestic and foreign databases such as China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database, VIP, Cochrane Library, PubMed, Embase, Web of Science. The search period was from the establishment of the database to January 2024. The scoping review method was used to screen, summarize, and analyze the included studies. Results A total of 10 studies were included, including 3 randomized controlled trial, 1 quasi experimental study, 5 retrospective studies and 1 case report. Preoperative exercise preparation includes completing relevant examinations and providing sufficient pain relief. The types of exercise include adaptive training, resistance training, and aerobic exercise. Monitor the patient’s symptoms, signs, and adverse reactions throughout the exercise process. Outcome measures include physical activity and function, pain, average length of hospital stay, and perioperative complications. Conclusions Preoperative exercise training has a positive effect on elderly patients with hip fracture. Elderly patients with hip fracture should be well prepared for preoperative exercise, based on adaptive training, with resistance exercise as the main focus, while monitoring the patient’s physical signs and adverse events during exercise.

Citation： PENG Tao, HE Yongqin, YI Dekun, ZHOU Yuanyuan, ZHANG Yumei. Preoperative exercise training in the pre-rehabilitation of elderly patients with hip fracture: a scoping review. West China Medical Journal, 2024, 39(6): 906-912. doi: 10.7507/1002-0179.202402154 Copy

1.	McDonough CM, Harris-Hayes M, Kristensen MT, et al. Physical therapy management of older adults with hip fracture. J Orthop Sports Phys Ther, 2021, 51(2): CPG1-CPG81.
2.	Veronese N, Maggi S. Epidemiology and social costs of hip fracture. Injury, 2018, 49(8): 1458-1460.
3.	Cui Z, Feng H, Meng X, Zhuang S, et al. Age-specific 1-year mortality rates after hip fracture based on the populations in mainland China between the years 2000 and 2018: a systematic analysis. Arch Osteoporos, 2019, 25,14(1): 55.
4.	Dyer SM, Crotty M, Fairhall N, et al. A critical review of the long-term disability outcomes following hip fracture. BMC Geriatr, 2016, 16(1): 158.
5.	Thomas T, Tubach F, Bizouard G, et al. The economic burden of severe osteoporotic fractures in the french healthcare database: the FRACTOS study. J Bone Miner Res, 2022, 37(10): 1811-1822.
6.	中華人民共和國國家衛生健康委員會醫政司. 老年髖部骨折診療與管理指南(2022 年版). 中華創傷骨科雜志, 2023, 25(4): 277-283.
7.	Sanz-Reig J, Salvador Marín J, Ferrández Martínez J, et al. Risk-factors for surgical delay following hip fracture. Rev Esp Cir Ortop Traumatol, 2017, 61(3): 162-169.
8.	楊陽, 馬信龍, 崔爽爽, 等. 老年髖部骨折延遲手術的影響因素分析. 中華骨科雜志, 2021, 41(15): 1046-1051.
9.	王劍, 孫新立, 朱亞斌, 等. 老年髖部骨折手術治療綠色通道的短期有效性. 中華創傷骨科雜志, 2018, 20(7): 578-582.
10.	北京護理學會骨科專業委員會, 中華醫學會骨科學分會護理學組, 中華醫學會創傷. 學分會護理學組中國老年髖部骨折圍術期護理專家共識(2023). 中華創傷骨科雜志, 2023, 25(5): 369-379.
11.	Peters MDJ, Marnie C, Tricco AC, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Implement, 2021(1): 3-10.
12.	World Health Organization. Integrated care for older people: guidelines on community-level interventions to manage declines in intrinsic capacity. Switzerland, 2017.
13.	Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol, 2005, 8(1): 19-32.
14.	Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med, 2018, 169(7): 467-473.
15.	朱美華, 孫利春. 術前適應性訓練對老年髖部骨折術后患者影響的研究. 護士進修雜志, 2017, 32(9): 823-834.
16.	韋懷籍, 王小芃, 周建飛. 預康復在老年股骨粗隆間骨折圍術期應用的臨床研究. 醫學理論與實踐, 2017, 30(13): 1894-1896, 1899.
17.	王妙維, 陳寶玉, 高強, 等. 老年股骨轉子間骨折術前康復訓練效果研究. 中國現代醫學雜志, 2018, 28(15): 92-95.
18.	Sawaguchi A, Momosaki R, Hasebe K, et al. Effectiveness of preoperative physical therapy for older patients with hip fracture. Geriatr Gerontol Int, 2018, 18(7): 1003-1008.
19.	劉佳鑫, 陳力, 段鑫, 等. 術前早期下地活動對老年髖部骨折患者術后生活自理能力的影響. 中國修復重建外科雜志, 2019, 33(3): 319-322.
20.	胡喜蓮, 劉曉磊, 王璐怡, 等. 術前康復訓練對行股骨頭置換術治療的老年股骨頸骨折患者術后功能恢復的影響. 廣西醫學, 2021, 43(17): 2054-2057.
21.	Liu J, Chen L, Long C, et al. A retrospective pilot study of preoperative mobilization program for older adults with hip fracture. Geriatr Nurs, 2021, 42(4): 908-914.
22.	Liu J, Chen L, Long C, et al. Effect of a preoperative mobilization program on perioperative complications and function recovery in older adults with femoral neck fracture. Geriatr Nurs, 2022, 44: 69-75.
23.	Skouras AZ, Antonakis-Karamintzas D, Tsolakis C, et al. Pre- and postoperative exercise effectiveness in mobility, hemostatic balance, and prognostic biomarkers in hip fracture patients: a study protocol for a randomized controlled trial. Biomedicines, 2023, 11(5): 1263.
24.	陳寶玉, 寧倩, 張澤瓊, 等. 基于加速康復理念術前步行訓練治療 101 歲股骨頸骨折患者一例. 華西醫學, 2023, 38(6): 954-957.
25.	Hayashi K, Janowski A, Lesnak JB, et al. Preoperative exercise has a modest effect on postoperative pain, function, quality of life, and complications: a systematic review and Meta-analysis. Phys Ther, 2023, 103(3): pzac169.
26.	Moran J, Wilson F, Hussey J, et al. The role of preoperative exercise therapy in intra-abdominal surgery: a systematic review. PROSPERO, 2015: CRD42015020546.
27.	Pouwels S, Fiddelaers J, Teijink JA, et al. Preoperative exercise therapy in lung surgery patients: a systematic review. Respir Med, 2015, 109(12): 1495-1504.
28.	Pouwels S, Stokmans RA, Willigendael EM, et al. Preoperative exercise therapy for elective major abdominal surgery: a systematic review. Int J Surg, 2014, 12(2): 134-140.
29.	范彩麗, 宋凌霞, 張莉, 等. 損害控制應用于老年髖部骨折圍手術期護理的研究進展. 護理學雜志, 2018, 33(4): 16-18.
30.	王超群, 常運鶴, 鄭洋, 等. 多學科醫護協作模式在老年髖部骨折圍術期的應用研究. 中國修復重建外科雜志, 2019, 33(10): 1283-1286.
31.	白井雙, 底瑞青, 黃崢, 等. 心臟起搏治療患者基于運動危險分層康復方案的構建與實施. 護理學雜志, 2023, 38(11): 33-37.
32.	《運動處方中國專家共識(2023)》專家組. 運動處方中國專家共識 (2023). 中國運動醫學雜志, 2023, 42(1): 3-13.

1. McDonough CM, Harris-Hayes M, Kristensen MT, et al. Physical therapy management of older adults with hip fracture. J Orthop Sports Phys Ther, 2021, 51(2): CPG1-CPG81.
2. Veronese N, Maggi S. Epidemiology and social costs of hip fracture. Injury, 2018, 49(8): 1458-1460.
3. Cui Z, Feng H, Meng X, Zhuang S, et al. Age-specific 1-year mortality rates after hip fracture based on the populations in mainland China between the years 2000 and 2018: a systematic analysis. Arch Osteoporos, 2019, 25,14(1): 55.
4. Dyer SM, Crotty M, Fairhall N, et al. A critical review of the long-term disability outcomes following hip fracture. BMC Geriatr, 2016, 16(1): 158.
5. Thomas T, Tubach F, Bizouard G, et al. The economic burden of severe osteoporotic fractures in the french healthcare database: the FRACTOS study. J Bone Miner Res, 2022, 37(10): 1811-1822.
6. 中華人民共和國國家衛生健康委員會醫政司. 老年髖部骨折診療與管理指南(2022 年版). 中華創傷骨科雜志, 2023, 25(4): 277-283.
7. Sanz-Reig J, Salvador Marín J, Ferrández Martínez J, et al. Risk-factors for surgical delay following hip fracture. Rev Esp Cir Ortop Traumatol, 2017, 61(3): 162-169.
8. 楊陽, 馬信龍, 崔爽爽, 等. 老年髖部骨折延遲手術的影響因素分析. 中華骨科雜志, 2021, 41(15): 1046-1051.
9. 王劍, 孫新立, 朱亞斌, 等. 老年髖部骨折手術治療綠色通道的短期有效性. 中華創傷骨科雜志, 2018, 20(7): 578-582.
10. 北京護理學會骨科專業委員會, 中華醫學會骨科學分會護理學組, 中華醫學會創傷. 學分會護理學組中國老年髖部骨折圍術期護理專家共識(2023). 中華創傷骨科雜志, 2023, 25(5): 369-379.
11. Peters MDJ, Marnie C, Tricco AC, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Implement, 2021(1): 3-10.
12. World Health Organization. Integrated care for older people: guidelines on community-level interventions to manage declines in intrinsic capacity. Switzerland, 2017.
13. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol, 2005, 8(1): 19-32.
14. Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med, 2018, 169(7): 467-473.
15. 朱美華, 孫利春. 術前適應性訓練對老年髖部骨折術后患者影響的研究. 護士進修雜志, 2017, 32(9): 823-834.
16. 韋懷籍, 王小芃, 周建飛. 預康復在老年股骨粗隆間骨折圍術期應用的臨床研究. 醫學理論與實踐, 2017, 30(13): 1894-1896, 1899.
17. 王妙維, 陳寶玉, 高強, 等. 老年股骨轉子間骨折術前康復訓練效果研究. 中國現代醫學雜志, 2018, 28(15): 92-95.
18. Sawaguchi A, Momosaki R, Hasebe K, et al. Effectiveness of preoperative physical therapy for older patients with hip fracture. Geriatr Gerontol Int, 2018, 18(7): 1003-1008.
19. 劉佳鑫, 陳力, 段鑫, 等. 術前早期下地活動對老年髖部骨折患者術后生活自理能力的影響. 中國修復重建外科雜志, 2019, 33(3): 319-322.
20. 胡喜蓮, 劉曉磊, 王璐怡, 等. 術前康復訓練對行股骨頭置換術治療的老年股骨頸骨折患者術后功能恢復的影響. 廣西醫學, 2021, 43(17): 2054-2057.
21. Liu J, Chen L, Long C, et al. A retrospective pilot study of preoperative mobilization program for older adults with hip fracture. Geriatr Nurs, 2021, 42(4): 908-914.
22. Liu J, Chen L, Long C, et al. Effect of a preoperative mobilization program on perioperative complications and function recovery in older adults with femoral neck fracture. Geriatr Nurs, 2022, 44: 69-75.
23. Skouras AZ, Antonakis-Karamintzas D, Tsolakis C, et al. Pre- and postoperative exercise effectiveness in mobility, hemostatic balance, and prognostic biomarkers in hip fracture patients: a study protocol for a randomized controlled trial. Biomedicines, 2023, 11(5): 1263.
24. 陳寶玉, 寧倩, 張澤瓊, 等. 基于加速康復理念術前步行訓練治療 101 歲股骨頸骨折患者一例. 華西醫學, 2023, 38(6): 954-957.
25. Hayashi K, Janowski A, Lesnak JB, et al. Preoperative exercise has a modest effect on postoperative pain, function, quality of life, and complications: a systematic review and Meta-analysis. Phys Ther, 2023, 103(3): pzac169.
26. Moran J, Wilson F, Hussey J, et al. The role of preoperative exercise therapy in intra-abdominal surgery: a systematic review. PROSPERO, 2015: CRD42015020546.
27. Pouwels S, Fiddelaers J, Teijink JA, et al. Preoperative exercise therapy in lung surgery patients: a systematic review. Respir Med, 2015, 109(12): 1495-1504.
28. Pouwels S, Stokmans RA, Willigendael EM, et al. Preoperative exercise therapy for elective major abdominal surgery: a systematic review. Int J Surg, 2014, 12(2): 134-140.
29. 范彩麗, 宋凌霞, 張莉, 等. 損害控制應用于老年髖部骨折圍手術期護理的研究進展. 護理學雜志, 2018, 33(4): 16-18.
30. 王超群, 常運鶴, 鄭洋, 等. 多學科醫護協作模式在老年髖部骨折圍術期的應用研究. 中國修復重建外科雜志, 2019, 33(10): 1283-1286.
31. 白井雙, 底瑞青, 黃崢, 等. 心臟起搏治療患者基于運動危險分層康復方案的構建與實施. 護理學雜志, 2023, 38(11): 33-37.
32. 《運動處方中國專家共識(2023)》專家組. 運動處方中國專家共識 (2023). 中國運動醫學雜志, 2023, 42(1): 3-13.

West China Medical Journal

Preoperative exercise training in the pre-rehabilitation of elderly patients with hip fracture: a scoping review

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