Table 1. Baseline characteristics of randomized trials included in the meta-analysis.
| Study | Country | Sample size | Age, mean±SD | Female, N (%) | Home-based activities | Time to initiation | Control activities | Exercise duration |
|---|---|---|---|---|---|---|---|---|
| Sherrington, 1997 | Australia | I: 20 C: 20 |
I: 80.0±8.1 C: 77.1±8.2 |
I: 12 (60.0) C: 19 (95.0) |
Weight-bearing exercise | Average 7 months after fractures | Usual care | 1mo |
| Tinetti, 1999 | USA | I: 148 C: 156 |
I: 80.5±7.0 C: 79.4±7.8 |
I: 121 (71.8) C: 126 (8.08) |
Strength and balance training, occupational therapy, environmental modifications | Immediately after discharge | Usual care | 12mo |
| Hauer, 2002 | Germany | I: 15 C: 13 |
I: 81.7±7.6 C: 80.8±7.0 |
I: 15 (100) C: 13 (100) |
High-intensity progressive resistance training and functional training | 6–8 weeks after surgery | Motor placebo activities (calisthenics, games, memory tasks whilst seated) | 6mo |
| Crotty, 2002 | Australia | I: 34 C: 32 |
I: 81.6 (78.2, 85.4)# C: 83.5 (76.6, 85.5)# |
I: 21 (61.8) C: 24 (75.0) |
ADL-related training, environmental assessment and modifications | Average 10 days after surgery | Routine hospital care and rehabilitation | 4mo |
| Sherrington, 2004 | Australia | I1: 40 I2: 40 C: 40 |
I1: 80.1±7.5 I2: 79.1±8.9 C: 77.2±8.9 |
I1: 30 (75.0) I2: 31 (77.5) C: 34 (85.0) |
I1: weight-bearing exercise I2: non-weight bearing exercise |
Average 153 days after fractures | No intervention | 4mo |
| Mangione, 2005 | USA | I1: 12 I2: 11 C: 10 |
I1: 79.8±5.6 I2: 77.9±7.9 C: 77.8±7.3 |
I1: 8 (66.7) I2: 7 (63.6) C: 8 (80.0) |
I1: Aerobic training I2: Resistance training |
Average 19.7 weeks after surgery | Receiving biweekly mailings on a variety of nonexercise topics | 12wk |
| Tsauo, 2005 | China | I: 13 C: 12 |
I: 74.1±12.0 C: 71.9±12.5 |
I: 10 (76.9) C: 10 (83.3) |
Strengthening, range-of-motion, balance, and functional exercise, practice of safe and efficient transfer techniques, adjustment of walking aids, adaption and modification of the home environment | Immediately after discharge | Continue exercise program given at bedside before discharge | 3mo |
| Ziden, 2008 | Sweden | I: 48 C: 54 |
I: 81.2±5.9 C: 82.5±7.6 |
I: 29 (60.4) C: 42 (77.8) |
ADL-related training, technical aids, information about surgical treatment and prognosis, support self-efficacy | Average 1 month after discharge | Usual care | 3wk |
| Mangione, 2010 | USA | I: 14 C: 12 |
I: 79.6±5.9 C: 82.0±6.0 |
I: 12 (85.7) C: 9 (75.0) |
Progressive resistance exercise | Average 6 months after fractures | Conventional TENS | 10wk |
| Orwig, 2011 | USA | I: 91 C: 89 |
I: 82.5±7.1 C: 82.3±6.9 |
I: 91 (100) C: 89 (100) |
Aerobic exercise, strength training, a self-efficacy based motivational component. | Within 15 days of the fractures | Usual care | 12mo |
| Shyu, 2013 | China | I1:101 I2: 99 C: 99 |
I1: 76.17±6.65 I2: 76.46±7.14 C: 76.91±8.20 |
I1: 68 (67.3) I2: 59 (59.6) C: 64 (64.6) |
I1: interdisciplinary care (geriatric consultation, rehabilitation focusing on relieving pain, enhancing range of motion, balance challenges, and aerobic capacity, discharge planning with post-hospital services) I2: comprehensive care (nutrition consultation, depression management, fall prevention, interdisciplinary care) |
1st day after surgery | Usual care | 12mo |
| Latham, 2014 | USA | I: 120 C: 112 |
I: 77.2±10.2 C: 78.9±9.4 |
I: 83 (69.2) C: 77 (68.8) |
Functional exercise, weight-bearing exercise | Within 24 months after fractures | Nutrition education | 6mo |
| Salpakoski, 2014 | Finland | I: 40 C: 41 |
I: 80.9±7.7 C: 79.1±6.4 |
I: 31 (77.5) C: 32 (78.0) |
Promotion Mobility rehabilitation program (ProMo), including strengthening and stretching exercises, balance training, function exercises, evaluation and modification of environmental hazards, guidance for safe walking | 44 to 239 days after fractures | Standard care | 12mo |
| Karlsson, 2016 | Sweden | I: 107 C: 98 |
I: 83.2±7.0 C: 82.6±6.4 |
I: 79 (73.8) C: 68 (69.4) |
Functional strength and balance training, modifications of home environment, pain management, nutrition advice | NR | Conventional care and rehabilitation | 10wk |
| Williams, 2016 | UK | I: 29 C: 32 |
I: 80.9±6.6 C: 78.0±8.3 |
I: 23 (79.3) C: 23 (71.9) |
Physical exercise, patient-held information workbook, goal-setting diary | Average 18.8 days after surgery | Usual care | 12wk |
| Stemmle, 2019 | Switzerland | I1: 43 I2: 44 C1: 44 C2: 42 |
I1: 83.2±7.4 I2: 83.5±7.1 C1: 85.5±6.0 C2: 84.6±6.9 |
I1: 34 (79.1) I2: 34 (77.3) C1: 35 (79.5) C2: 34 (81.0) |
I1: simple home exercise program + 800 IU/d vitamin D3 I2: simple home exercise program + 2000 IU/d vitamin D3 |
Within 12 days after surgery | C1: Standard physiotherapy + 800 IU/d vitamin D3 C1: Standard physiotherapy + 2000 IU/d vitamin D3 |
12mo |
| Magaziner, 2019 | USA | I: 105 C: 105 |
I: 80.3±8.0 C: 81.2±8.8 |
I: 80 (76.2) C: 81 (77.1) |
Strength exercise, plantar flexion exercise, endurance exercise, nutritional counseling | Average 13.8w after hospitalization | Active range-of-motion exercises, sensory-level TENS | 16wk |
| Taraldsen, 2019 | Norway | I: 70 C: 73 |
I: 84.9±6.6 C: 82.7±5.7 |
I: 54 (77.1) C: 56 (76.7) |
Weight-bearing exercise | Average 4 months after surgery | Usual care | 10wk |
| Soukkio, 2021 | Sweden | I: 61 C: 60 |
I: 83±6 C: 80±7 |
I: 50 (82.0) C: 41 (68.3) |
Strength, balance, mobility, and function exercise; counseling on physical activity; brief advice on nutrition | Within 2 weeks of discharge from hospital | Usual care | 12mo |
| Huang, 2023 | USA | I: 17 C: 17 |
I: 78.6±7.3 C: 77.8±7.8 |
I: 7 (41.1) C: 6 (35.3) |
Strength, balance, and function exercises | Average 116 days after hospitalization | Active range-of-motion exercises, TENS | 16wk |
| Taylor, 2023 | Australia | I: 20 C: 18 |
I: 78±9 C: 80±9 |
I: 10 (50.0) C: 13 (72.2) |
Moderate-intensity walking intervention | Average 82 days after fractures | Standard care | 12wk |
# Median (quartiles)
C: control group; I: intervention group; mo: months; NR: not reported; TENS: transcutaneous electrical nerve stimulation; wk: weeks.