Perioperative interventions, such as analgesia regimens, timing of surgery and type of anaesthesia, are recommended in clinical practice guidelines to address barriers to early mobilisation and optimise physical function outcomes.
The aim of this systematic review and meta-analysis was to determine the effectiveness of perioperative interventions on achieving early mobilisation and improving physical function after hip fracture.
Twenty-eight studies were included in this systematic review and meta-analysis, in which participated a total of 8,192 patients with a fractured proximal femur and a mean age of 80 years. Interventions were grouped into six categories: analgesia, pathways and models of care, rehabilitation delivery modes, surgical protocols, nutritional supplements and clinical supervision.
The results of this study indicated that:
The authors concluded that many barriers to early mobilisation are potential amenable to perioperative interventions. The delivery of these perioperative interventions varies substantially between hospital sites and their impact on the ability to mobilise early postoperatively and restoration of physical function is not yet well understood. Future aetiologic studies are required to understand and model the causal mechanisms by which early mobilisation and physical function after hip fracture can be improved by perioperative interventions.
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