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.	中华人民共和国国家卫生健康委员会医政司. 老年髋部骨折诊疗与管理指南(2022 年版). 中华创伤骨科杂志, 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.	杨阳, 马信龙, 崔爽爽, 等. 老年髋部骨折延迟手术的影响因素分析. 中华骨科杂志, 2021, 41(15): 1046-1051.
9.	王剑, 孙新立, 朱亚斌, 等. 老年髋部骨折手术治疗绿色通道的短期有效性. 中华创伤骨科杂志, 2018, 20(7): 578-582.
10.	北京护理学会骨科专业委员会, 中华医学会骨科学分会护理学组, 中华医学会创伤. 学分会护理学组中国老年髋部骨折围术期护理专家共识(2023). 中华创伤骨科杂志, 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.	朱美华, 孙利春. 术前适应性训练对老年髋部骨折术后患者影响的研究. 护士进修杂志, 2017, 32(9): 823-834.
16.	韦怀籍, 王小芃, 周建飞. 预康复在老年股骨粗隆间骨折围术期应用的临床研究. 医学理论与实践, 2017, 30(13): 1894-1896, 1899.
17.	王妙维, 陈宝玉, 高强, 等. 老年股骨转子间骨折术前康复训练效果研究. 中国现代医学杂志, 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.	刘佳鑫, 陈力, 段鑫, 等. 术前早期下地活动对老年髋部骨折患者术后生活自理能力的影响. 中国修复重建外科杂志, 2019, 33(3): 319-322.
20.	胡喜莲, 刘晓磊, 王璐怡, 等. 术前康复训练对行股骨头置换术治疗的老年股骨颈骨折患者术后功能恢复的影响. 广西医学, 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.	陈宝玉, 宁倩, 张泽琼, 等. 基于加速康复理念术前步行训练治疗 101 岁股骨颈骨折患者一例. 华西医学, 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.	范彩丽, 宋凌霞, 张莉, 等. 损害控制应用于老年髋部骨折围手术期护理的研究进展. 护理学杂志, 2018, 33(4): 16-18.
30.	王超群, 常运鹤, 郑洋, 等. 多学科医护协作模式在老年髋部骨折围术期的应用研究. 中国修复重建外科杂志, 2019, 33(10): 1283-1286.
31.	白井双, 底瑞青, 黄峥, 等. 心脏起搏治疗患者基于运动危险分层康复方案的构建与实施. 护理学杂志, 2023, 38(11): 33-37.
32.	《运动处方中国专家共识(2023)》专家组. 运动处方中国专家共识 (2023). 中国运动医学杂志, 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. 中华人民共和国国家卫生健康委员会医政司. 老年髋部骨折诊疗与管理指南(2022 年版). 中华创伤骨科杂志, 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. 杨阳, 马信龙, 崔爽爽, 等. 老年髋部骨折延迟手术的影响因素分析. 中华骨科杂志, 2021, 41(15): 1046-1051.
9. 王剑, 孙新立, 朱亚斌, 等. 老年髋部骨折手术治疗绿色通道的短期有效性. 中华创伤骨科杂志, 2018, 20(7): 578-582.
10. 北京护理学会骨科专业委员会, 中华医学会骨科学分会护理学组, 中华医学会创伤. 学分会护理学组中国老年髋部骨折围术期护理专家共识(2023). 中华创伤骨科杂志, 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. 朱美华, 孙利春. 术前适应性训练对老年髋部骨折术后患者影响的研究. 护士进修杂志, 2017, 32(9): 823-834.
16. 韦怀籍, 王小芃, 周建飞. 预康复在老年股骨粗隆间骨折围术期应用的临床研究. 医学理论与实践, 2017, 30(13): 1894-1896, 1899.
17. 王妙维, 陈宝玉, 高强, 等. 老年股骨转子间骨折术前康复训练效果研究. 中国现代医学杂志, 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. 刘佳鑫, 陈力, 段鑫, 等. 术前早期下地活动对老年髋部骨折患者术后生活自理能力的影响. 中国修复重建外科杂志, 2019, 33(3): 319-322.
20. 胡喜莲, 刘晓磊, 王璐怡, 等. 术前康复训练对行股骨头置换术治疗的老年股骨颈骨折患者术后功能恢复的影响. 广西医学, 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. 陈宝玉, 宁倩, 张泽琼, 等. 基于加速康复理念术前步行训练治疗 101 岁股骨颈骨折患者一例. 华西医学, 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. 范彩丽, 宋凌霞, 张莉, 等. 损害控制应用于老年髋部骨折围手术期护理的研究进展. 护理学杂志, 2018, 33(4): 16-18.
30. 王超群, 常运鹤, 郑洋, 等. 多学科医护协作模式在老年髋部骨折围术期的应用研究. 中国修复重建外科杂志, 2019, 33(10): 1283-1286.
31. 白井双, 底瑞青, 黄峥, 等. 心脏起搏治疗患者基于运动危险分层康复方案的构建与实施. 护理学杂志, 2023, 38(11): 33-37.
32. 《运动处方中国专家共识(2023)》专家组. 运动处方中国专家共识 (2023). 中国运动医学杂志, 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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