Summary of findings 3. Summary of findings: post‐hospital studies.

Mobility strategies compared with control (e.g. usual care) after hip fracture surgery in the post‐hospital setting
Patient or population: adults following hip fracture surgery Settings: post‐hospital Intervention: mobility strategiesa Comparison: non‐provision controlb
Outcomes	Illustrative comparative risks* (95% CI)		Relative effect (95% CI)	No of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Assumed risk	Corresponding risk
	Controlc	Intervention
Mobilityd ‐ overall analysis   Using different mobility scales: mPPT (range 0 to 36), POMA (range 0 to 30), SPPB (range 0 to 12), PPME (range 0 to 12). A higher score indicates better mobility.   Follow‐up: range 2 months to 12 months	In the control group, the mean scores for the outcomes were: mPPT (23.3), POMA (20.7), SPPB (range 6 to 7.72), PPME (10.1)	SMD 0.32 higher (0.11 higher to 0.54 higher)	SMD 0.32 (0.11 to 0.54)	761 (7)	⊕⊕⊕⊕ Highe	Overall, there is a small (based on Cohen's effect sizesf) increase in mobility compared with control (SMD 0.32).   Re‐expressing the results using the 12‐point SPPB, the intervention group scored 0.89 points higher (95% CI 0.30 to 1.50). Small meaningful change for SPPB: 0.27 to 0.55 points; substantial meaningful change: 0.99 to 1.34 points (Perera 2006).   Types of intervention in included trials: gait, balance and functional exercise: 5 studies; multiple types: 2 studies.
Walking speedg ‐ overall analysis   Measured using metres/second (m/s) and metres/minute (m/min). A higher score indicates faster walking.   Follow‐up: range 1 month to 12 months	The mean walking speed score in the control group ranged from 0.44 m/s to 0.97 m/s, and 20 m/min to 59.4 m/min.	SMD 0.16 higher (0.04 higher to 0.29 higher)	SMD 0.16 (0.04 to 0.29)	1067 (14)	⊕⊕⊕⊕ Highh	There is a small increase in walking speed compared with control (SMD 0.16).   Re‐expressing the results using gait speed (m/sec), there was an increase in gait speed of 0.05 m/s in the intervention group (MD 0.05, 95% CI 0.01 to 0.09). Small meaningful change for walking speed is 0.04 to 0.06 m/s (Perera 2006).   Types of intervention in included trials: gait, balance and functional exercise: 7 studies; resistance exercise: 3 studies; endurance exercise: 1 study; multiple types: 3 studies.
Functioningi ‐ overall analysis   Using different functioning scales: FSQ (range 0 to 36), BI (range 0 to 100), AM‐PAC daily activity (range 9 to 101), COPM (range 0 to 20), LEFS (range 0 to 80), NEADL (range 0 to 66). A higher score indicates better functioning.   Follow‐up: range 3 months to 12 months	In the control group, the mean scores for the outcomes were: FSQ (24.8), BI (94.5), AM‐PAC (58.6), COPM (6.54), LEFS (28.8), NEADL (range 14.2 to 43.2).	SMD 0.23 higher (0.10 higher to 0.36 higher)	SMD 0.23 (0.10 to 0.36)	936 (9)	⊕⊕⊕⊕ Highj	Overall, there is a small increase in functioning compared with control (SMD 0.23).   Re‐expressing the results using the BI, the intervention group scored 1.4 points higher (95% CI 0.6 to 2.1). MID for the BI (post‐hip surgery) is typically 9.8 (Unnanuntana 2018).   Types of intervention in included trials: gait, balance and functional exercise: 4 studies; resistance exercise: 2 studies; multiple types: 2 studies; other: 1 study
HRQoL using EQ‐ 5D (range 0 to 1), SF‐36 (range 0 to 100), SF‐12 (range 0 to 100), and WHOQOL‐BREF (range 0 to 130). A higher score indicates better quality of life.   Follow‐up: range 3 months to 6 months	In the control group, the mean scores for the outcomes were: EQ‐5D (range 0.6 to 0.75), SF‐36 (range 48 to 63), SF‐12 (45.5), WHOQOL‐BREF (13.2).	SMD 0.14 higher (0.00 lower to 0.29 higher)	SMD 0.14 (0.00 to 0.29)	785 (10)	⊕⊕⊕⊝ Moderatek	SMD was calculated for 5 trials with EQ‐5D, 3 trials with SF‐36, 1 trial with SF‐12, 1 trial with WHOQOL‐BREF.   Re‐expressing the results using the EQ‐5D (0 to 1 scale), there was an increase in quality of life of 0.01 in the intervention group (95% CI ‐0.007 to 0.08). MID for the EQ‐5D is typically 0.074 (Walters 2005).   Re‐expressing the results using the SF‐36 (0 to 100 scale), there was an increase in quality of life of 3 points in the intervention group (95% CI ‐0.6 to 5.7). MID for SF‐36 typically 3 to 5 (Walters 2003).   Mobility strategies probably make little important difference to patient‐reported health‐related quality of life compared with control.   Types of intervention in included trials: gait, balance and functional exercise: 4 studies; resistance exercise: 3 studies; endurance exercise: 1 study; multiple types: 1 study; other: 1 study
Mortality   Follow‐up: range 3 months to 12 months	Short term: 35 per 1000l	Short term: 35 per 1000 (14 to 72)	Short term: RR 1.01 (0.49 to 2.06)	Short term: 737 (8)	⊕⊕⊕⊝ Moderatem	Overall, there is moderate‐certainty evidence that mobility strategies probably make little or no difference to mortality compared to control in the short term.   It is unclear whether mobility strategies reduce mortality in the long term as the certainty of evidence is low and the 95% CI includes both a reduction in the risk of mortality and an increase in the risk of mortality.   Types of intervention in included trials: gait, balance and functional exercise: 3 studies; resistance exercise: 3 studies; multiple types: 5 studies.
	Long term: 71 per 1000l	Long term: 52 per 1000 (28 to 97)	Long term: RR 0.73 (0.39 to 1.37)	Long term: 588 (4)	⊕⊕⊝⊝ Lown
Adverse event: number of people who were re‐admitted   Follow‐up: range 1 month to 12 months	231 per 1000l	199 (120 to 328)	RR 0.86 (0.52 to 1.42)	206 (2)	⊕⊕⊝⊝ Lowo	The evidence is of low certainty: the intervention may decrease the number of re‐admissions by 14%; however, the 95% CI includes the possibility of both a 48% reduction and a 42% increase.   Types of intervention in included trials: multiple types: 1 study; other: 1 study.
*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). AM‐PAC: Activity Measure for Post Acute Care; BI: Barthel Index; CI: confidence interval; COPM: Canadian Occupational Performance Measure; EQ5D: EuroQoL‐5Dl; FSQ: Functional StaRR: risk ratio; HRQoL: Health‐Related Quality of Life; LEFS: Lower Extremity Functional Scale; MID: minimal important difference; MD: mean difference; mPPT: modified Physical Performance Test; tus Questionnaire; NEADL: Nottingham Extended Activities of Daily Living; PME: Physical Performance and Mobility Examination; POMA: Performance Oriented Mobility Assessment; PWHOQOL BREF: World Health Organization Quality of LIfe short version; SMD: standardised mean difference; SF12: Short Form‐12 SF36: Short Form‐36; SPPB: Short Physical Performance Battery.
GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.

^a Postoperative care programmes such as exercises, physical training and muscle stimulation, used at various stages in rehabilitation, which aim to improve walking and minimise functional impairments.
^bA non‐provision control is defined as no intervention, usual care, sham exercise (the exercise was intended to be a control, or appeared to be of insufficient intensity and progression to have beneficial effects on mobility) or a social visit.
^cThe all‐studies population risk was based on the number of events and the number of participants in the control group.
^dMobility, measuring the ability of a person to move. Scales may measure a number of aspects of mobility (e.g. sit to stand, walking, turning, stairs).
^eNot downgraded for risk of bias, as point estimate increased from 0.32 to 0.38 and CI remained close to zero (95% CI from (0.11 to 0.54) to (‐0.04 to 0.79)) upon removal of the trials at a high risk of bias in one or more items.
^fCohen's effect size 0.2 is described as small, 0.5 as medium/moderate effect, 0.8 as large effect (Sawilowsky 2009).
^gWalking speed, measured using distance/time.
^hNot downgraded for risk of bias, as point estimate reduced from 0.16 to 0.14 and CI remained close to zero (95% CI from (0.04 to 0.29) to (‐0.08 to 0.36) upon removal of the trials at a high risk of bias in one or more items.
ⁱFunctioning, using functioning scales.
^jNot downgraded for risk of bias, as point estimate increased and CI remained above zero upon removal of the trials at a high risk of bias in one or more domains.
^kDowngraded one level for risk of bias (removing studies with high risk of bias in one or more domains had a marked impact on results).
^lOur illustrative risks for dichotomous outcomes were based on the proportion calculated from the number of people who experienced the event divided by the number of people in the group, for the control group in those trials included in the analysis for that outcome.
^mNot downgraded for risk of bias, as results were essentially unchanged with removal of the trials at a high risk of bias in one or more domains. Downgraded by one level due to imprecision (few events and wide CI).
ⁿDowngraded one level for risk of bias (removing studies with high risk of bias in one or more domains had an important impact on results) and one level for imprecision (few events and wide CI).
^oWe downgraded one level for risk of bias, as both trials were at a high risk of bias in one or more domains. Downgraded one level for imprecision (few events and wide CI).