Targeting mobility after hip fracture surgery

The evidence for the use of additional mobility strategies to improve outcomes after hip fracture surgery has greater certainty in the post‐hospital setting than for the in‐hospital setting.

In the post‐hospital setting, there is high‐certainty evidence that mobility strategies lead to small, clinically meaningful improvements in mobility and walking speed compared with control. Mobility strategies also lead to a small, non‐clinically meaningful improvement in functioning (high‐certainty evidence) and probably a slight increase in health‐related quality of life that may not be meaningful (moderate‐certainty evidence).

Such strategies probably make little or no difference to short‐term mortality compared with control (moderate‐certainty evidence) and may make little or no difference to long‐term mortality or hospital re‐admission (low‐certainty evidence).

It is unclear whether mobilisation strategies affect re‐operation, pain or the number of people who fall (low and very-low‐certainty evidence). However, there is moderate‐certainty evidence that the number of falls is probably reduced by 21% compared with control.

Mobility strategies included exercises, physical training and muscle stimulation, and were used at various stages in rehabilitation. In the post-hospital setting, interventions that included gait, balance and functional tasks had high‐certainty evidence for effectiveness at increasing mobility.