# Restoration of the hip function after a hip fracture in older adults

> Students’ learning task for BIP week on the theme of older adults.

## Background: Evidence-Based Physical Therapy (EBP)
Evidence-Based Physical Therapy (EBP) uses the best research evidence with clinical expertise and user’s preferences to produce the most appropriate and effective care. At week 43 in 2024, a Blended Intensive program (BIP) was held at Charles University in the Czech Republic regarding EBP. The program opened with welcome words from the president of The European Network of Physiotherapy in Higher Education (ENPHE) and covered the basis of EBP, with teachers highlighting the main challenges in different physical therapy fields.

More than 43 physiotherapy students and 9 teachers from five universities participated:
* Savonia University of Applied Sciences, Finland
* Universidade da Coruña, Spain
* Charles University Prague, Czech Republic
* Universidad Europea de Madrid, Spain
* CEERRF, France

Students worked together to write articles on themes including sport, prevention, injuries, neurological diseases, respiratory diseases, cardiovascular diseases, children, and older adults. This specific task involved conducting a mini-review and using the PEDro scale to assess study quality.

## Hip Fracture Rehabilitation
Hip fractures are common injuries for older adults due to physical changes associated with aging, such as arthritis, osteoporosis, loss of balance, visual impairment, and slow reflexes. As life expectancy increases, more adults require rehabilitation for this condition. 

The aim of this mini-review was to assess the outcomes of different multicomponent rehabilitation programs designed to restore the functionality of the fractured hip.

## Methodology
The search criteria were established as follows:
* **Study Type:** Randomized Controlled Trials
* **Sample Size:** 5 articles (one for each group member)
* **Publication Date:** Last 5 years
* **Subject Criteria:** Over 60 years old with hip fractures
* **Keywords:** Hip fracture, elderly adults, physical therapy

Initially, 1320 articles were identified. After applying filters, 42 articles remained, from which the following 5 were selected:
1. Che et al. (2023)
2. Karlsson et al. (2020)
3. Magaziner et al. (2019)
4. Mangione et al. (2023)
5. Ryan et al. (2024)

The reliability of these articles was assessed using the PEDro Scale, resulting in an average score of 6, categorized as "good."

## Conclusion
The review suggests that while multicomponent home-based programs show beneficial results, they are not significantly superior to non-specific rehabilitation programs. However, these programs remain useful for maintaining a good quality of life for older adults. The project provided students with valuable experience in research methods and the application of critical thinking in professional practice.

## Authors
* **Linda Sněhotová**, physiotherapy student, Charles University, Czech Republic
* **Anas Khida**, physiotherapy student, Charles University, Czech Republic
* **Lucía Piastra**, physiotherapy student, University of A Coruña, A Coruña, Spain
* **Álvaro Villar**, physiotherapy student, University of A Coruña, A Coruña, Spain
* **Rebecca Petersen**, physiotherapy student, Universidad Europea de Madrid, Spain
* **Dagmar Pavlu**, Physiotherapist, Assoc. Prof. Charles University, Czech Republic
* **Ivana Vláčilová**, Physiotherapist, PhD., Charles University, Czech Republic
* **Marja Äijö**, PT, PhD Principal Lecturer of gerontology and rehabilitation, Savonia, University of Applied Sciences, Kuopio, Finland
* **Veronica Robles García**, PhD. PT. OT. Lecturer, University of A Coruña, A Coruña, Spain
* **Beatriz Martínez Toledo**, PT. Lecturer at University of A Coruña, A Coruña, Spain
* **Montserrat Fernández Pereira**, PT, Lecturer at University of A Coruña, A Coruña, A Coruña, Spain
* **Lorena Canosa Carro**, PT, MSc, PhD. Lecturer at Universidad Europea de Madrid, Spain
* **Adrien Pallot**, PT, MSc, Lecturer at CEERRF, France

## References
* Mangione, K. K., Craik, R., Zhang, L. Q., & Magaziner, J. (2023). Effect of Multicomponent Home-Based Training on Gait and Muscle Strength in Older Adults After Hip Fracture Surgery: A Single Site Randomized Trial. Archives of physical medicine and rehabilitation, 104(2), 169–178. https://doi.org/10.1016/j.apmr.2022.08.974
* Che, Y. J., Qian, Z., Chen, Q., Chang, R., Xie, X., & Hao, Y. F. (2023). Effects of rehabilitation therapy based on exercise prescription on motor function and complications after hip fracture surgery in elderly patients. BMC musculoskeletal disorders, 24(1), 817. https://doi.org/10.1186/s12891-023-06806-y
* Magaziner, J., Mangione, K. K., Orwig, D., Baumgarten, M., Magder, L., Terrin, M., Fortinsky, R. H., Gruber-Baldini, A. L., Beamer, B. A., Tosteson, A. N. A., Kenny, A. M., Shardell, M., Binder, E. F., Koval, K., Resnick, B., Miller, R., Forman, S., McBride, R., & Craik, R. L. (2019). Effect of a Multicomponent Home-Based Physical Therapy Intervention on Ambulation After Hip Fracture in Older Adults: The CAP Randomized Clinical Trial. JAMA, 322(10), 946– 956. https://doi.org/10.1001/jama.2019.12964
* Ryan, A. S., Beamer, B. A., Gruber-Baldini, A. L., Craik, R. L., Golden, J., Guralnik, J., Hochberg, M. C., Mangione, K. K., Orwig, D., Rathbun, A. M., & Magaziner, J. (2024). Effects of Multicomponent Home-Based Intervention on Muscle Composition, Fitness, and Bone Density After Hip Fracture. The journals of gerontology. Series A, Biological sciences and medical sciences, 79(5), glae078. https://doi.org/10.1093/gerona/glae078
* Karlsson, Å., Lindelöf, N., Olofsson, B., Berggren, M., Gustafson, Y., Nordström, P., & Stenvall, M. (2020). Effects of Geriatric Interdisciplinary Home Rehabilitation on Independence in Activities of Daily Living in Older People With Hip Fracture: A Randomized Controlled Trial. Archives of physical medicine and rehabilitation, 101(4), 571–578. https://doi.org/10.1016/j.apmr.2019.12.007