Effect of Lower-Limb Progressive Resistance Exercise After Hip Fracture Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Studies

Objective Although several studies have reported the effect of progressive resistance exercise (PRE) after hip fracture surgery, little is known about the functional efficacy of PRE. Thus, we conducted a meta-analysis to evaluate whether PRE can improve (1) mobility and (2) other physical functions in elderly patients after hip fracture surgery. Methods Eight randomized controlled trials investigating the effects of PRE after hip fracture surgery were retrieved from a PubMed, Embase, and Cochrane Library search. Our pair-wise meta-analysis used a fixed or random effects model. Results PRE significantly improved participants' overall physical functions after hip fracture surgery compared with the control group (standardized mean difference = 0.408; 95% confidence interval, 0.238-0.578; P <.001). It was particularly effective in the areas of mobility (standardized mean difference = 0.501; 95% confidence interval, 0.297-0.705; P <.001), activities of daily living, balance, lower-limb strength or power, and performance task. Conclusions Our meta-analysis revealed that PRE after hip fracture surgery improves mobility, activities of daily living, balance, lower-limb strength or power, and performance task outcomes. Because of the small sample size in this meta-analysis and considering the increasing incidence of hip fractures, there is a need for large-scale randomized controlled trials to confirm the functional improvement and adverse effects of PRE.