Home-based rehabilitation and telerehabilitation in the functional recovery of older adults: A systematic review
DOI:
https://doi.org/10.62827/fb.v27i7.1250Keywords:
Hip Fractures; Physical Therapy; Functional Physical Performance; Elderly; Muscle Strength.Abstract
Introduction: Hip fractures are a major cause of functional disability in older adults, and are associated with high morbidity and mortality, loss of independence, and high costs to health care systems. Objective: To evaluate the effects of physical therapy and functional rehabilitation programs on the recovery of older adults after a hip fracture, comparing them to conventional care. Methods: A systematic review with meta-analysis was conducted, including randomized clinical trials published between 2021 and 2026. Studies that compared structured rehabilitation programs with usual care were eligible. Statistical analyses were performed using Review Manager (RevMan) software. Risk of bias was assessed using the Cochrane Risk of Bias (RoB 2) tool, and the quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results: The meta-analysis demonstrated a significant benefit of structured physical therapy on physical performance, with a mean improvement of 2.01 points on the Short Physical Performance Battery (SPPB) compared to conventional treatment (MD = 2.01; 95% CI: 1.26–2.76; p < 0.00001), with no significant heterogeneity. For functional independence (SMD = 0.15; 95% CI: −0.31 to 0.60), muscle strength (SMD = 0.22; 95% CI: −0.43 to 0.87), and anxiety (SMD = 0.18; 95% CI: −0.14 to 0.50), trends favorable to the interventions were observed, though they did not reach statistical significance. Conclusion: Structured physical therapy demonstrated a significant benefit in the physical performance of older adults following a hip fracture. The other outcomes showed positive trends; however, the evidence is insufficient to confirm statistically significant benefits. Further trials with larger sample sizes and standardized protocols are needed to consolidate the evidence in this area.
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Copyright (c) 2026 Thais Adriane Santos Lemos, Daniel Augusto Carlos Silva, Jorge Antônio de Moura Leite, Isabella Lo Presti Hydalgo, Vítor Ângelo Silva (Autor)
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